1 in 5 patients over the age of 60 suffer from peripheral arterial disease. Individuals suffering from peripheral arterial disease, or PAD, are at a higher risk of coronary artery disease, stroke, or heart attack. If left untreated, PAD can lead to wounds, gangrene, and limb amputationWhile the pain primarily occurs in the legs, it can also be felt in other parts of the body, including the arms, stomach, hip, head, and kidneys.
Peripheral arterial disease (PAD), develops when there is excessive plaque buildup on the artery walls, causing the arteries to narrow. Arteries deliver oxygen-rich blood from the heart to other parts of the body. When plaque builds up, it restricts the flow of blood, oxygen, and glucose. This obstruction causes pain in the leg as the muscles and tissues are starved of oxygen and other essential nutrients.
Fatty plaque accumulation develops through a process called atherosclerosis, which is the primary cause of peripheral arterial disease. Certain factors- such as smoking, old age, a history of heart disease, high blood pressure, diabetes, and a sedentary lifestyle- may put people at an increased risk for developing PAD.
Up to 40% of Americans who report leg pain while walking have
Peripheral Arterial Disease
The most common symptom associated with peripheral arterial disease is leg pain when walking or exercising. This condition is also referred to as claudication. Fat and cholesterol build up on the artery walls can impede healthy blood flow. When this happens, your muscles are not able to receive oxygen and, therefore, can start to ache and cramp, especially during exercise. Symptoms that are associated with peripheral arterial disease are listed below.
As peripheral arterial disease progresses, you may experience pain even when you are lying down. The pain can even become intense enough to disrupt your sleep. Resting your legs by hanging them at the edge of your bed or a brief walk can stimulate blood flow.
Atherosclerosis, the most common cause of PAD, develops when excessive plaque buildup is present in the artery wall. The plaque is usually made up of cholesterol and fat buildup. The condition starts when the plaque builds enough to narrow an artery, restricting blood flow. Next, the plaque may become inflamed or brittle, causing a rapture that triggers a blood clot to form. The blood clot will narrow the artery further or block it entirely. Blockages in the arteries can lead to life-threatening conditions. For instance, if the carotid artery is blocked, it can cause a stroke. If the blockages remain in the legs’ peripheral arteries, it can lead to pain, skin discoloration, sores, and difficulty in walking. In extreme cases, complete loss of circulation to the feet and legs can lead to gangrene and limb loss. If you do not have atherosclerosis, the following conditions may also cause Peripheral Artery Disease.
Smoking is a major factor to the onset of peripheral artery disease. Tobacco smoke damages the arteries’ inner layers. As the body attempts to these damaged arteries, plaque often builds upon the damaged area. Blood clots (thrombi) can also develop as a result. Thrombi tend to stick to the artery walls, narrowing the pathway for blood to flow even further. Research proves that smoking cessation is effective in reducing your risk of PAD.
Lack of exercise can also increase your risk of PAD. If you are suffering from PAD, establishing a regular exercise regiment will significantly improve your painful symptoms. Regular workouts improve blood flow and boosts overall health by regulating blood sugar and blood pressure. It also lowers cholesterol and reduce plaque buildup.
Diabetics are at high risk of PAD if they have consistently high blood sugar. High blood glucose is connected to plaque buildup in the arteries. Controlling Type 2 diabetes through the proper diet, exercise, and medication helps in reducing PAD risks. Patients diagnosed with high blood pressure and high cholesterol are also at increased risks of PAD. Maintaining a healthy diet and exercise can help reduce blood pressure and cholesterol, which is key to reducing PAD risks.
PAD is not always linked to plaque in the arteries. It can also develop from blood vessel inflammation, which causes narrowed arteries.
At Monterey Bay Vascular, we offer comprehensive diagnosis and develop customized treatments for peripheral arterial disease. We understand that no two patients’ conditions are similar. Our full-service vascular lab provides state-of-the-art tests ensure that we address each patient case quickly and accurately. Our team has extensive experience in our specialized field and use advanced tools to achieve limb-saving results even in the most challenging cases.
To help diagnose PAD, we will start with a thorough physical examination. The doctor will also want to learn about your symptoms, personal health history, risk factors, and family health history. The doctor will ask you several questions regarding your medical conditions, such as diabetes, heart disease, and kidney disease. They will also ask you have experienced pain or cramps in your leg while walking or exercising.
The doctor will also ask about your family history of PAD and other heart diseases. You will also discuss smoking habits, both current and past. After gathering this information, the doctor will proceed to perform a detailed physical examination. The process involves checking for weak pulses in your leg and listening for poor blood flow in the legs using a stethoscope. They will also check for any problems on your legs, such as sores, swelling, and pale skin.
Ankle-brachial index (ABI test) helps diagnose PAD. This test compares the blood pressure in your arm with the blood pressure in your ankle. The doctor uses a pressure cuff coupled with an ultrasound device. Sometimes, the doctor may request that you walk on a treadmill while they take the readings before and immediately after the exercise. The procedure will help the doctor to capture the severity of the narrowed arteries.
At Monterey Bay Vascular, we also use ultrasound-guided procedures to determine whether a specific vein or artery is blocked or opens. The procedure is non-invasive, meaning that you will not experience any pain. The technique visualizes the artery with sound waves that measure blood flow your valves. After the procedure, you'll receive a thorough consultation. The doctor will recommend the most effective treatment option to optimize lower extremity blood flow.
Treatment will help reduce leg pain, promote healing of sores and increase the mobility of the affected limb. Doctors utilize two main ultrasound tests. The first method is the Doppler ultrasound utilized to locate areas with blockages or reduced blood flow. An ultrasound technician uses a handheld device that sends sound waves through the arteries to measure how fast blood flows. The second method is the segmental Doppler pressure testing that checks various parts of the legs for blocked or narrowed arteries. The procedure is similar to the ABI test, but the ultrasound device will amplify the sound of blood flow, making it easy to measure blood pressure.
Angiography is a minimally invasive test that helps to visualize and diagnose blockages inside veins and arteries. During this test, the doctor will insert a thin tube that injects a special dye. The dye will project blood vessels on an X-ray. As the dye is introduced to the arteries and veins, fluoroscopy imaging captures the detailed images to see the extent of the blockages in the arteries.
Doctors also take a sample of your blood to measure the levels of cholesterol and triglycerides. Blood samples are also used to check for diabetes.
MRA tests are conducted to examine the structure of the arteries in your leg. However, the doctor will speak to you extensively before moving forward with this test. Magnetic resonance angiography is not recommended for people with metal implants in their bodies.