Peripheral arterial disease, often called PAD, occurs when fatty plaque builds up in the peripheral arteries, which carry blood to the arms and legs. According to the National Heart, Lung, and Blood Institute, more than 8 million people in the United States age 40 or older have PAD.
As plaque builds up in the peripheral arteries, it can cause the arteries to narrow, limiting blood flow from the heart to the extremities. While some cases of PAD may be managed effectively with lifestyle changes, treatment is necessary to prevent severe complications, including infections, critical limb ischemia and even amputation.
What are the different types of peripheral arterial disease?
There are two types of peripheral arterial disease, differing in the part of the body that’s affected:
- Lower-extremity PAD reduces blood flow to the legs and feet.
- Upper-extremity PAD reduces blood flow to the arms and hands.
Lower-extremity PAD is much more common, accounting for up to 90 percent of cases.
What causes peripheral arterial disease?
Peripheral arterial disease is caused by atherosclerosis, the formal name for a buildup of fat and cholesterol in an artery. Atherosclerosis can affect arteries in any part of the body—when it develops in the coronary arteries, for example, it can limit blood flow to the heart.
While anyone can develop PAD, certain factors make it more likely. Risk factors for peripheral arterial disease include:
- Certain medical conditions, including diabetes, high blood pressure, kidney disease or high cholesterol
- Diet high in saturated fat
- Excessive stress
- Family history of PAD, heart disease or vascular disease
- Inactive lifestyle
- Obesity
- Smoking
Race and age also have an impact on the risk of developing PAD. Risk increases with age, with most cases diagnosed in those who are 65 or older. Peripheral arterial disease is also more common and more likely to cause complications among African Americans.
What are the symptoms of peripheral arterial disease?
Symptoms of PAD are more likely to occur as the condition worsens. Symptoms on an affected limb may include:
- Lower temperature when compared with the opposite arm or leg
- Pain, numbness, tingling or heaviness in the muscles
- Pale or bluish skin color
- Poor nail and hair growth
- Slow-healing or nonhealing wounds
- Weak or absent pulse
Those who have lower-extremity PAD often experience intermittent claudication, which is muscle cramping that occurs when the muscles don’t get enough blood during movement. In many cases, the symptoms of peripheral arterial disease improve when at rest and worsen when a limb is being used.
How is peripheral arterial disease diagnosed?
If you’re experiencing the symptoms of PAD, your medical provider will first perform a thorough physical exam, which may include a test known as ankle-brachial index (ABI). ABI involves comparing blood pressure in the lower body with blood pressure in the arms.
If the results of an ABI show diminished blood flow, additional tests may be used to confirm a diagnosis. This may include:
- Angiography to show the location and severity of artery blockages
- Blood tests to check for underlying risk factors, such as high cholesterol
- Doppler ultrasound to locate areas of reduced blood flow
Another test, known as a 6-minute walking test, may be used to determine how severely PAD affects a person’s ability to function.
How is peripheral arterial disease treated?
Treatment for PAD varies depending on the severity of the disease. A treatment plan will focus on reducing symptoms, improving quality of life and lowering the risk of complications. Treatment may include:
Lifestyle changes
The habits used to protect heart health can also help keep PAD from worsening. Eating a diet that’s low in saturated fat and sodium, being physically active, finding healthy ways to manage stress and maintaining a healthy weight can all be helpful. Because smoking is the most significant risk factor for PAD, it’s important to quit if you smoke.
Medication
Medications may be prescribed to mitigate risk factors, treat symptoms and prevent complications. Blood thinners, statins and blood pressure medications may all be used as part of a treatment plan for PAD.
Supervised exercise
Physical activity can help relieve PAD symptoms by improving circulation in the legs and reducing inflammation. Your provider may recommend participating in a supervised exercise program or using a home-based exercise program to safely and regularly move your body in a meaningful way.
Surgery
If nonsurgical treatment options don’t alleviate PAD symptoms, surgery may be needed to restore blood flow. Three types of surgery are used to treat peripheral arterial disease:
- Angioplasty with stenting is the most common vascular surgery for peripheral arterial disease. During this catheter-based procedure, a small balloon-tipped tube is woven to the blocked artery, where it is opened, causing plaque to move to the sides of the artery. Once blood flow is restored, a mesh tube called a stent may be left in the artery to keep it from narrowing again.
- Atherectomy is a minimally invasive, catheter-based procedure that removes plaque from a blocked artery, restoring blood flow. During this procedure, a sharp blade is placed at the tip of the catheter, which is used to cut away and remove plaque buildup.
- Bypass surgery may be used to treat PAD causing severe symptoms, including nonhealing wounds or severe tissue damage. During this procedure, a blood vessel from another part of the body is used to “bypass” the blocked peripheral artery, opening up a new path for blood flow.
Choose NGPG for peripheral arterial disease treatment
If you’re experiencing PAD symptoms, you don’t have to travel far to get the care you need. At Northeast Georgia Physicians Group (NGPG) Vascular Center, our vascular specialists offer diagnosis and treatment for vascular disease, including peripheral arterial disease.
Our services include comprehensive treatment options for PAD, encompassing both nonsurgical therapies and vascular surgery. When surgery is needed, we provide patients with minimally invasive options whenever possible, allowing for a quicker recovery and a lower risk of complications.
Endovascular procedures used to treat PAD, such as angioplasty, are performed in one of the endovascular suites at Northeast Georgia Medical Center, which are equipped with advanced technology and imaging equipment.
