What is Peripheral Arterial Disease(PAD) and is it fatal?
What is Peripheral Arterial Disease?
Peripheral artery disease (also called peripheral arterial disease) is a common condition in which narrowed arteries reduce blood flow to the arms or legs.In peripheral artery disease (PAD), the legs or arms — usually the legs — don’t receive enough blood flow to keep up with demand. This may cause leg pain when walking
(claudication) and other symptoms.Peripheral artery disease is usually a sign of a buildup of fatty deposits in the arteries (atherosclerosis).
Atherosclerosis causes narrowing of the arteries that can reduce blood flow in the legs and, sometimes, the arms.Peripheral artery disease treatment includes exercising, eating a healthy diet and not smoking or using tobacco.
One in five people with PAD, if left undiagnosed and untreated, will have a heart attack, stroke, or death within five years. Untreated PAD can have other serious consequences, including leg muscle pain, discomfort during exercise, and loss of mobility.
Symptoms of Peripheral artery disease?
About half the people diagnosed with PA0D have no symptoms. For those with symptoms, the most common first symptom is painful leg cramping that occurs with exercise and is relieved by rest. This is known as intermittent claudication. During rest, the muscles need less blood flow, so the pain disappears. It may occur in one or both legs. This depends on the location of the clogged or narrowed artery.
Other symptoms of PAD may include:
- Changes in the skin, including decreased skin temperature, or thin, brittle, shiny skin on the legs and feet.
- Weak pulses in the legs and the feet.
- Gangrene (dead tissue due to lack of blood flow)
- Hair loss on the legs.
- Impotence
- Wounds that won’t heal over pressure points, such as heels or ankles.
- Numbness, weakness, or heaviness in muscles.
- Pain (described as burning or aching) at rest, commonly in the toes and at night while lying flat.
- Paleness when the legs are elevated.
- Reddish-blue discoloration of the extremities.
- Restricted mobility
- Severe pain when the artery is very narrow or blocked
- Thickened, opaque toenails
How is Peripheral artery disease diagnosed and evaluated?
Ankle-brachial index,or ABI: This painless exam compares the blood pressure in your lower legs to the blood pressure in your arms.It takes only a few minutes and can be performed by your healthcare professional as part of a routine exam. A normal ABI is 1.00 or greater. A value less than or equal to 0.90 is considered abnormal,and,in severe disease, it’s less than 0.4. If your ABI results are normal or borderline (.91 to .99), an exercise treadmill ABI and/or a toe-brachial index test also may be done.
- Doppler ultrasound: Doppler ultrasound is a special ultrasound technique that can help detect areas of restricted blood flow through an artery.
- Catheter angiography: This minimally invasive imaging exam relies on a contrast agent and x-rays to show blood flow in the arteries in the legs and to pinpoint any blockages that may be present. The contrast agent is injected through a tube or catheter that is usually placed through a blood vessel in the groin.
- CT angiography(CTA): CT angiography uses a CT scanner to produce detailed views of the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.
- MR angiography(MRA): MR angiography is a non-invasive test that gives information similar to that of a CT without the ionizing radiation.
How to treat Peripheral artery disease?
Lifestyle changes such as dietary modifications, exercise and smoking cessation often are the first choices for patients with early-stage PAD. Other interventions may be needed to restore the blood flow:
Angioplasty: In an angioplasty procedure, an interventional radiologist threads a catheter through a blood vessel to the affected artery and inflates a small balloon to reopen it. In some cases, the insertion of a stent is required to help keep the artery open. Stents are either balloon-expandable or self-expanding metallic scaffolds that remain permanently in the blood vessel after implantation.
Bypass surgery: Surgeons perform bypass surgery by grafting a vessel from another part of your body or using a synthetic graft made of fabric, allowing blood to flow around, or bypass, the blocked or narrowed artery.
Catheter-directed Thrombolysis: In this minimally invasive treatment, an interventional radiologist uses a catheter to reach the site of the blockage and injects a drug to dissolve the blood clot. This typically requires an overnight infusion.
Atherectomy: This minimally invasive procedure uses a catheter to reach the site of the blockage. There, a small blade or laser is deployed to remove the arterial plaque. The catheter captures the collected plaque in a chamber in the tip. The process can be repeated to treat additional plaque.
How to prevent Peripheral artery disease?
To prevent PAD and PVD, take care of yourself: get regular exercise, eat a healthy diet, and don’t smoke. It’s also important to take steps to control other conditions you may have like high blood pressure, high cholesterol, and diabetes. Ask your doctor about any symptoms you have. If you can catch the conditions early on, it’s possible to prevent milder forms from getting worse.
Can Peripheral artery disease be reversed?
Peripheral artery disease (PAD) happens when your arteries harden and narrow due to a buildup of plaque, made up of fats and other substances in your bloodstream. You get PAD, also called peripheral arterial disease, in the arteries that carry blood to your arms and legs.
If blood can’t get to these areas, tissue damage (and eventually tissue death) can occur. If it’s not controlled, PAD can lead to a stroke, heart attack, Kidney disease, or amputation of your foot, leg, or arm.There’s no cure for the disease. But lifestyle changes, exercise, and medication can slow the progression of PAD and possibly reverse its symptoms.