Peripheral Artery Disease

Peripheral Arterial Disease (PAD) is also known as atherosclerosis, poor circulation, or hardening of the arteries.  The legs and feet (lower extremity) are the part of the body most commonly affected by PAD.

Symptoms

Many people are affected by PAD, yet they do not have symptoms.   Because atherosclerosis may occur throughout the body and not just in the legs, individuals with PAD are at a higher risk for suffering an early heart attack or stroke.

In most people, the first noticeable symptom of PAD is a painful cramping of leg muscles during walking called intermittent claudication. When a person rests, the cramping goes away.  This leg pain can be severe enough to deter a person from normal walking.

In patients whose PAD is more severe, insufficient blood flow to the feet and legs may cause a burning/aching pain in the feet and toes while resting. This is referred to as rest pain. The pain will occur particularly at night while lying flat and is relieved with dangling the legs or feet.

In other patients with more severe PAD, the symptoms may include toe and foot sores that do not heal. In these patients with tissue loss, it is important to correct the blood flow abnormality to prevent limb amputation.

Diagnostic Tools
Many tests are used to diagnose PAD. The single most important test is a thorough history and physical examination by a qualified and experienced vascular specialist.

Additional tests may be used to define the severity of the PAD and may include:

• Doppler ultrasound exam of an extremity
• Angiography
• CT Angiography

Treatment Options
Treatment options vary and depend on the overall health of the patient and the severity of the PAD. In most cases, the treatment is focused on improving overall cardiovascular health. This involves lifestyle changes (such as quitting smoking, exercise, and weight loss) and occasionally medications (such as cholesterol-lowering drugs).

In more advanced cases of PAD, such as in patients with rest pain or tissue loss, the treatment options include:

• Bypass Surgery
• Endovascular Therapy