Peripheral Arterial Disease
Plaque is a sticky substance of cholesterol, calcium and fibrous tissue. Plaque can cause arteries to become narrow and stiff, a process called atherosclerosis—also known as hardening of the arteries. People with P.A.D. have a greater chance of having coronary heart disease, heart attack, stroke, and transient ischemic attack (mini-stroke).
Who is at Risk?
People at risk include those who smoke, have diabetes or are older than 50. Other risk factors include high blood pressure, high cholesterol, coronary heart disease, stroke, or a family history of these conditions. Another group of risk factors, known as metabolic syndrome, includes having abdominal obesity, high triglyceride level (a type of fat in the blood), low level of HDL (“good”) cholesterol, high blood pressure and high blood sugar.
Symptoms of P.A.D.
Many people have no symptoms, while others may experience:
● Pain or numbness in the legs or lower body (claudication) while walking or exercising
● Slow-healing sores on the toes, feet, or legs
● Skin that is pale or has a blue cast to it
● One leg has a lower temperature than the other
● Toenails that are weak or slow-growing
● Less hair growth on the legs
● Erectile dysfunction (more common in men with diabetes)
Tests and Treatments
You may be given an Ankle-Brachial Index (ABI) test to compare the blood pressure in your ankle and your arm, which are normally the same. If the blood pressure in your ankle is significantly lower, that could be a sign of narrowing leg arteries. Ultrasound may be used to determine which arteries are blocked. You may be asked to walk on a treadmill to see if you experience any problems while walking. A magnetic resonance angiogram (MRA) may be performed to find the location and condition of a blocked blood vessel. Another test to pinpoint the location of a blocked artery is the arteriogram, in which dye is injected into the artery and an x-ray is taken.
Treatments include lifestyle changes and medication. Bypass grafting surgery may be necessary to alleviate a blocked artery. The surgeon uses another blood vessel or a tube to go around the blocked part of the artery. Angioplasty is a procedure where a thin tube with a balloon on the end is inserted into the artery near the point of blockage. The balloon expands and widens the artery. A stent (small man-made tube) may be inserted to keep the artery open after the angioplasty procedure has been performed. If it is necessary to remove plaque from an artery, an atherectomy may be performed using either a laser or a catheter with a small blade to cut away the plaque from the artery wall.