PAD is a common yet potentially devastating circulatory condition. Although some of the roughly 12 million American PAD sufferers experience debilitating pain, others may not notice any outward signs of the disease.
That’s why early detection of PAD is so critical.
Use this guide to gain a better understanding of PAD and its symptoms. If you are in a high-risk demographic or are experiencing similar symptoms to those described below, make an appointment to see a doctor as soon as possible.
Peripheral artery disease (PAD) is a progressive blood disorder that usually manifests in leg pain, although arms can be affected, as well.
It’s caused by atherosclerosis, a buildup of plaque (fat) in the arteries that restricts the blood flow to extremities, limiting the oxygen and nutrients that can reach those areas. Thus, the body’s ability to heal those areas is reduced more and more until, in extreme cases, the tissue below the artery blockage dies (known as gangrene).
Certain factors increase your likelihood of developing PAD, including:
Think of all the functions your blood does when it circulates through your legs–keeping them warm, nourishing the skin, healing wounds–and you’ll get an idea of the warning signs that something is wrong with your circulation:
Your doctor’s first step in diagnosing PAD is a simple review of your medical history and a clinical exam, checking the pulses in your feet and other physical signs of bad artery blood flow such as hair loss on the legs, skin changes, and cool extremities.
Doctors can diagnose PAD in the following ways:
Ankle Brachial Index (ABI) Test: In healthy people, blood pressure in the legs should be slightly higher than that in the arms. An ABI compares the blood pressure from both respective areas after cuffs are applied and removed from your ankles and arms.
The pressure in your legs is then divided by that in your arms to reveal your ABI ratio. If it’s 0.9 or less (meaning your legs are getting at most 90% of the blood flow of your arms), you’re considered positive for PAD. The lower the ratio, the greater the severity of the disease. For example, an ABI value between 0.4 and 0.8 is considered moderate, while less than 0.40 indicates severe PAD.
Arterial duplex ultrasound: ABI tests are often paired with this test in which an ultrasound device called a Doppler is used to show narrowing or blockages in the arteries.
Pulse volume recording (PVR): Like an arterial duplex ultrasound, a PVR test also uses Doppler to measure blood speed and flow. The difference is it also records blood pressure.
Toe Brachial Index (TBI), also called Photoplethysmography (PPG): Patients with rigid ankle blood vessels may have difficulty with the ABI Test, making it necessary to compare blood pressure in the arms with that in the toes, instead. The exam is similar to ABI except that an infrared light sensor is used and the PAD diagnosis cutoff is 0.8 or lower.
Treadmill test: An exercise test can confirm or rule out PAD if it’s in doubt, as the ABI score will decline after exercise if there is PAD and lower limb pain being caused by intermittent claudication.
We may also want to include more advanced tests like CT (computed tomography) or MR (magnetic resonance) angiograms, which use computerized image processing that lets us view vascular disease three-dimensionally.
PAD will not resolve on its own–the buildup of plaque in the arteries will not go away without medical intervention. It must be treated or you will be at risk of PAD worsening and causing intermittent claudication (leg muscle pain, cramping, and fatigue), heart attack, stroke, critical limb ischemia (necessitating amputation), or even death.
While it may be tempting to do nothing about asymptomatic PAD, studies have shown that cases of mild or asymptomatic PAD are the most likely to worsen over a 12-month period.
Lifestyle changes such as eating healthier and exercising more can slow PAD progression, and in some cases, reverse its effects. However, without changing your habits that led to you developing PAD in the first place, the disease is liable to recur even after surgical intervention.
Simple, “DIY” efforts such as walking, stopping smoking, and cutting back your alcohol intake may be enough to relieve PAD symptoms.
When it comes to medical interventions, your primary options are medication and surgery.
Medication can include:
Surgery to address the blocked arteries can take one of many forms, depending on the location and severity of the damaged blood vessel:
Minimally invasive treatments:
Minimally invasive PAD treatments such as angioplasty are going to offer you faster recovery times and carry fewer risks than major surgery. That’s why we specialize in those at VasCare.
If you’re experiencing extremity discomfort, we can determine if you have PAD and design a course of treatment to get you on the road to better health.