Peripheral Artery Disease
Arm Artery Disease or, Peripheral arterial disease (PAD) occurs when plaque builds up on the inside walls of the arteries that carry blood from the heart to the head, internal organs, and limbs. PAD is also known as atherosclerotic peripheral arterial disease.
At least half of the people who have peripheral arterial disease (PAD) don't have any signs or symptoms of the disease. People who do have signs or symptoms may have pain when walking or climbing stairs, which may be relieved after resting. This pain is called intermittent claudication. Blood brings oxygen to the muscles, but during exercise, muscles need more blood flow. If there is a blockage in the blood vessels, muscles won't get enough blood. If a person has intermittent claudication and exercises while in pain, his or her muscles may be harmed. When resting, the muscles require less blood flow and the pain goes away. Claudication is more likely in people who also have atherosclerosis in other arteries, such as the heart and brain. About 10 percent of people with PAD have intermittent claudication.
Other signs and symptoms of PAD include:
- Pain, numbness, aching, and heaviness in the muscles
- Cramping in the legs, thighs, calves, and feet
- A weak or absent pulse in the legs or feet
- Sores or wounds on toes, feet, or legs that heal slowly, poorly, or not at all
- Color changes in skin, paleness, or blueness (called cyanosis)
- A decreased temperature in one leg compared to the other leg
- Poor nail growth and decreased hair growth on toes and legs
- Erectile dysfunction, especially among people with diabetes
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CAUSES & RISK FACTORS
The most common cause of peripheral arterial disease (PAD) is atherosclerosis. When atherosclerosis affects the arteries of the limbs, it is called PAD. The exact cause of atherosclerosis is unknown in the majority of cases. In atherosclerosis, the plaque that builds up on artery walls is made up of fat, cholesterol, calcium, and other substances in the blood. Smoking, diabetes, a high blood cholesterol level, and high blood pressure increase the risk of atherosclerosis.
Major risk factors for developing PAD include:
Smoking. Smoking is more closely related to developing PAD than any other risk factor. Smoking increases the risk of developing PAD three to five times. On average, smokers who develop PAD experience symptoms 10 years earlier than nonsmokers who develop PAD. Stopping smoking will slow the progress of PAD. Smoking even one or two cigarettes daily can interfere with the treatment for PAD. Smokers and diabetics have the greatest risk of complications from PAD, including gangrene in the leg from decreased blood flow.
Chronic or serious illnesses, such as diabetes. One in three people over age 50 with diabetes is likely to have PAD. Anyone over age 50 with diabetes should be screened for PAD.
Other diseases and conditions, such as:
- Kidney disease
- High blood pressure or a family history of it
- A high cholesterol level or a family history of it
- Heart disease or a family history of it
- A family history of stroke
- Age: Men who are older than age 50 and women who are older than age 55 are at higher risk for PAD
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Peripheral Arter Disease Diagnosis
Peripheral arterial disease (PAD) is diagnosed based on general medical and family history, history of leg or heart problems, personal risk factors, a physical exam, and test results. An accurate diagnosis is critical, because people with PAD face a six to seven times higher risk of heart disease or stroke than the rest of the population. PAD is often diagnosed after symptoms are reported. If you have PAD, your doctor also may want to look for signs of coronary artery disease (CAD).
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Medicines may be prescribed to:
- Lower high cholesterol levels and high blood pressure
- Thin the blood to prevent clots from forming due to low blood flow
- Dissolve blood clots
- Help improve pain in the legs that is the result of walking or climbing stairs (claudication)
Some medicines lower the level of low density lipoprotein (LDL) cholesterol. LDL is the "bad" cholesterol. The higher the LDL level in the blood, the greater the chance of heart disease. Medicines may include statins, such as lovastatin, simvastatin, pravastatin, fluvastatin, and atorvastatin. Other medicines may include ezetimibe, gemfibrozil, and certain binding agents.
PAD Surgeries or Special Procedures
Surgery may be necessary if blood flow in a limb is completely or almost completely blocked. In bypass grafting surgery, the doctor uses a blood vessel from another part of your body or a tube made of synthetic (man-made) material to make a graft. This graft bypasses the blockage in the artery, allowing blood to flow around it. Surgery does not cure PAD, but it may increase blood flow to the limb.
Angioplasty may be performed to restore blood flow through a narrowed or blocked artery. During the procedure, a thin tube (catheter) is inserted into a blocked artery and a small balloon on the tip of the catheter is inflated. When the balloon is inflated, plaque is pushed against the artery walls. This causes the artery to widen, restoring blood flow. A stent, a tiny mesh tube that looks like a small spring, is now used in most angioplasties. Some stents are coated with medicine to help prevent the artery from closing again.
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Westchester Vascular Surgeons
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Make an appointment at one of our Westchester Heart & Vascular locations. For physician information or to find a physician, call (877) WMC-VEIN (877-962-8346).
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