Peripheral Arterial Disease

Description:

Peripheral Arterial Disease (PAD) is a circulatory disorder that primarily affects the arteries outside the heart and brain, most commonly those supplying the limbs. It’s characterized by a narrowing or blockage of these arteries due to the buildup of fatty deposits (atherosclerosis), restricting blood flow to the extremities.

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Etiology/Risk Factors:

PAD typically stems from atherosclerosis, where plaque accumulates along the arterial walls, narrowing the blood vessels and impairing blood flow. 

Notable factors which increase the risk of developing PAD include: 

• Smoking
• Diabetes
• High blood pressure
• High cholesterol
• Chronic Kidney Disease
• Advanced age
• Obesity
• Sedentary lifestyle

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Symptoms:

Common symptoms of PAD involve pain, cramping, or fatigue in the legs, especially during physical activity. This discomfort, known as intermittent claudication, typically improves with rest.

As PAD progress, individuals may experience pain even at rest, non-healing wounds, and skin changes like hair loss or ulcer on the legs and feet.

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Diagnostics Tests & Procedures:

1. Ankle-Brachial Index (ABI): This simple test measures the blood pressure at the ankle and compares it to the blood pressure in the arm. A lower ratio suggests reduced blood flow to the legs.
2. Doppler Ultrasound: This non-invasive imaging technique uses sound waves to visualize blood flow and assess any blockages or narrowing the arteries.
3. Angiography: A contrast dye is injected into the arteries, and subsequent X-ray imaging reveals any blockages or narrowing.

Treatment:

Management of PAD may involve any combination of lifestyle changes, medications, and surgical interventions. Lifestyle modifications include quitting smoking, adopting a healthy diet, regular exercise, and controlling blood pressure and cholesterol levels. Medications like antiplatelets, blood thinners, and cholesterol-lowering drugs may be prescribed. In cases of significant arterial blockages, procedures such a atherectomy, angioplasty, and/or stent placement may be necessary to restore proper blood flow.

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References:

1. Zemaitis MR, Boll JM, Dreyer MA. Peripheral Arterial Disease. [Updated 2023 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430745/
2. NIH Publication No. 21-HL-5837 December 2021
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