Peripheral Artery Disease: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Peripheral artery disease, or simply peripheral arterial disease, is a common disorder characterized by reduced blood flow to the arms and legs due to restricted arteries.

The hallmark of peripheral artery disease (PAD) is insufficient blood flow to the arms, legs, or both, not enough to support the body's needs. Other symptoms like claudication, or leg pain during walking, could result from this.

Atherosclerosis, or the accumulation of fatty deposits in the arteries, is typically indicated by peripheral arterial disease. Blood flow to the arms and legs may be compromised by arterial constriction brought on by atherosclerosis.

Treatments for peripheral artery disease include exercise, a balanced diet, and giving up tobacco usage and smoking.

Causes Of Peripheral Artery Disease

Peripheral artery disease is often caused by a build-up of fatty, cholesterol-containing deposits (plaques) on arterial walls. This process is known as atherosclerosis. There is less blood flowing via the arteries.

Atherosclerosis affects arteries throughout the body. When it affects the arteries that provide blood to the extremities, the outcome is peripheral arterial disease.

Peripheral artery disease is less commonly caused by the following factors:

• Blood vessel infection
• Harm to the legs or arms
• Changes to the muscles or ligaments
• Radiation exposure

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Symptoms Of Peripheral Artery Disease

 Peripheral artery disease patients frequently experience minimal or nonexistent symptoms. Some walkers experience leg pain or claudication.

Claudication is characterized by arm or leg cramps or pain that stops when you rest but returns when you exercise. The most common location for pain is the calf. The discomfort ranges from mild to really severe. If your legs hurt a lot, it could be hard to walk or do other physical activity.

Additional peripheral artery disease indicators and symptoms include:

• Feeling cold in the foot or lower leg, particularly when compared to the other side
• Numbness or weakness in the leg
• The feet or legs may pulse very weakly or not at all.
• Painful cramps may occur in one or both hip, thigh, or calf muscles during certain activities, such as walking or climbing stairs.
• Shiny skin on the lower body
• Changes in the skin tone of the legs
• Reduced development of toenails
• Sores on the feet, legs, or toes that never go away
• Pain and cramps experienced when writing, crocheting, or doing other manual tasks involving the arms
• Legs where the hair grows less or not at all

If peripheral vascular disease gets worse, you could experience pain whether you're at rest or lying down. The pain may cause interruption to sleep. You can stroll or drape your legs over the edge of the bed to temporarily relieve the pain.

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Risk Factors Of Peripheral Artery Disease

Individuals with diabetes or smoking have a significantly higher risk of developing peripheral artery disease. Peripheral artery disease is also associated with the following other factors:

• Inheritance of peripheral artery disease, heart disease, or stroke
• Increased cholesterol raised blood pressure
• Increases in the amino acid homocysteine increase the risk of coronary artery disease.
• Getting older, especially if you're over 65 (or 50 with cardiovascular risk factors)
• An obese person has a BMI of 30 or over.

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Diagnosis Of Peripheral Artery Disease

A medical practitioner's examination is required to make the diagnosis of peripheral artery disease. Usually, questions about your symptoms and medical history will be asked.

A weak or nonexistent pulse in the affected area can be a sign of peripheral artery disease. The following tests can be used to identify peripheral artery disease:

• Blood tests: Blood tests are used to check for illnesses associated with PAD, such as diabetes, high triglycerides, and high cholesterol.
• Ankle-brachial index (ABI): The test is commonly used to diagnose PAD. By contrasting the blood pressure between the arm and ankle, it does this. Someone might ask you to walk on a treadmill. Blood pressure readings can be taken before and immediately after exercise to assess the arteries.
• Ultrasound on the limbs or feet: This test uses sound waves to assess blood flow through blood vessels. Doppler ultrasound is a special type of ultrasonography that is used to detect narrowed or obstructed arteries.
• Angiography: Using X-rays, magnetic resonance imaging (MRI), or computerized tomography (CT), this examination checks for arterial blockages. Before imaging, a blood artery is given a dye (contrast) injection. The dye enhances the visibility of the arteries in the test photos.

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Treatment Of Peripheral Artery Disease

The following goals are pursued in peripheral artery disease treatment:

Manage symptoms, such as sore legs, to ensure that exercising is comfortable.

Improve vascular health to reduce the chance of heart attacks and strokes.

Treatment for peripheral artery disease involves lifestyle changes and sometimes medication.

Lifestyle adjustments can help reduce symptoms, especially in the initial phases of peripheral artery disease. Quitting smoking is the most important thing you can do to reduce your chance of problems. Walking or participating in another regular, scheduled activity (supervised exercise training) can significantly reduce symptoms.

Medications

If peripheral artery disease (PAD) is the cause of your symptoms, your doctor may suggest medication. Medications used to treat PAD include:

• Drugs that reduce cholesterol: Statins are a class of drugs commonly provided to individuals with peripheral arterial disease. Statins help reduce plaque that clogs arteries and harmful cholesterol. The drugs also lessen the risk of heart attacks and strokes. If you have PAD, find out from your doctor what your recommended cholesterol levels are.
• Anti-Hypertensive drugs: Arteries can become rigid and hardened by uncontrolled hypertension. The blood flow could slow as a result of this. Find out what your optimum blood pressure target is by speaking with your healthcare provider. If your blood pressure is elevated, your healthcare provider can suggest taking medication to lower it.
• Medications to prevent blood clots: Peripheral artery disease (PAD) is linked to reduced blood flow to the limbs. Consequently, drugs may be given to improve blood flow. Aspirin or clopidogrel (Plavix) are two more medications that can be used to prevent blood clotting.
• Medications for limb pain: The drug cilostazol thins the blood and dilates blood vessels. The blood supply to the limbs is increased. In particular, the drug lessens leg pain in those with peripheral artery disease. Two of this medication's common negative effects are headache and diarrhea. Pentoxifylline is one medication alternative. It is generally less effective than cilostazol, even though adverse effects are infrequent with this medication.

Surgery

Surgery or angioplasty may be necessary in certain cases to address peripheral arterial disease that is causing claudication:

• Angioplasty and stent insertion: This method is intended to unclog clogged arteries. It can diagnose and treat a clogged vessel at the same time. The medical practitioner inserts a small, flexible tube called a catheter into the narrowed section of the artery. A little balloon is inflated to improve blood flow and widen the occluded artery. A stent, which is a thin wire mesh tube, can be put into the artery and kept open.
• Steer clear of surgery: The surgeon bypasses the obstructed artery by using an artificial blood vessel or a healthy blood vessel from another part of the body.
• Thrombolytic drugs: If a blood clot is blocking an artery, it may be possible to inject an intravenous clot-dissolving drug straight into the affected artery.

Prevention Of Peripheral Artery Disease

The best way to prevent peripheral vascular disease-related leg pain is to lead a healthy lifestyle. This suggests:

• Give up smoking.
• Control your blood sugar levels.
• Exercise regularly, but discuss the type and quantity that work best for you with your doctor.
• Maintain your ideal weight.
• Regulate blood pressure and cholesterol.

Complications Of Peripheral Artery Disease

Peripheral artery disease problems associated with atherosclerosis include:

• Serious peripheral ischemia: In this case, tissue dies as a result of an infection or injury. Non-healing open sores on the limbs are one of the symptoms. One possible course of treatment is amputation of the affected limb.
• Strokes and heart attacks: Plaque buildup in the arteries may affect the blood vessels in the heart and brain.

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