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Published on April 26, 2012

Vascular Health: Peripheral Artery Disease

In Brief

  • Peripheral artery disease affects more than eight million people in the U.S. alone.
  • One of the main risk factors for PAD is a person’s age. Other risks factors can include smoking, diabetes, obesity, family history of peripheral artery disease, high blood pressure, high cholesterol, excess levels of homocysteine, a protein component that helps build and maintain tissue.
  • It’s important to talk to your doctor about your risk factors and any symptoms you have been experiencing.

Vascular disease is among the leading causes of death in the United States. In the U.S. alone, peripheral artery disease affects more than eight million people.

What is peripheral artery disease?

“The vascular system of the human body is made up of veins and arteries, collectively called blood vessels,” says Gregory Domer, M.D., chief of the Division of Vascular Surgery at Crozer-Chester Medical Center. “Peripheral artery disease (PAD), also known as peripheral vascular disease (PVD), is the partial or total blockage of the arteries outside of the heart and occurs most frequently in the arteries of the pelvis and legs.”

Am I at risk of PAD?

“One of the main risk factors for PAD is a person’s age,” says Marat Goldenberg, M.D., Crozer-Keystone vascular surgeon. “This is because the disease becomes more common as we get older. Also, people who smoke or have diabetes have a greater risk of developing peripheral artery disease due to reduced blood flow.”

Other risk factors can include:

  • Obesity
  • Family history of peripheral artery disease
  • High blood pressure
  • High cholesterol
  • Excess levels of homocysteine, a protein component that helps build and maintain tissue

How do I know if I’m suffering from PAD?

While one common symptom is leg pain or leg fatigue, many people with PAD experience no symptoms at all,” Domer adds. “If a person does experience other symptoms, they can include a change in the color of your legs, hair loss on your legs and feet, or a weak pulse in your legs and feet.”

Several simple screening tests can help to detect PAD, most of which are non-invasive and painless. Some of these tests may be performed in a primary care physician’s office, while others may be performed by a vascular specialist or in a vascular lab. The Mayo Clinic suggests the following screening tests:

  • Physical exam: Your doctor may be able to find signs of PAD by performing a simple physical.
  • Peripheral artery disease scan. This test can quickly determine if there is any impairment in the circulation to the limbs. The exam can identify blockages in the leg arteries and tell how severe the blockage is and whether treatment is needed.
  • Ankle-Brachial Index (ABI): This primary diagnostic test is universally indicated for all patients at high risk for PAD. The test compares blood pressure in your ankle to blood pressure in your arm, and it can show how well blood is flowing in your limbs.
  • Ultrasound: Special ultrasound imaging techniques, such as Doppler ultrasound, can help your doctor evaluate blood flow through your blood vessels and identify blocked or narrowed arteries.
  • Angiography: By injecting a dye (contrast material) into your blood vessels, your doctor can view blood flow through your arteries as it happens during this test.

How is PAD treated?

“The main goals of treatment are to relieve the pain in your legs/feet and to stop the progression of narrowing arteries within your body,” Goldenberg adds. “Depending on how severe their PAD is, some people can accomplish these goals with lifestyle changes. Others can be treated with medication or surgery.”

In most cases, minimally invasive options can be used to open and unblock closed or narrowed arteries. For instance, angioplasty is a procedure that uses a small balloon on the tip of a catheter to reopen the artery and flatten the blockage. Stents can also be placed, which act as a support structure to hold the vessel open. Thrombolytic therapy works by injecting a clot-dissolving drug into your artery to break up the clot. In some cases, patients may require bypass surgery, which allows blood to flow around blocked/narrowed arteries using other vessels in the body, or a synthetic fabric vessel.

What can I do to avoid PAD?

You should think about whether or not you fall into any of the “risk” categories, and try to change it. Like quitting smoking; losing weight; eating a healthy, balanced diet; and exercising more. It’s important to talk to your doctor about getting your diabetes and high blood pressure under control, and to find treatment for any other risk factors that may require medication. Remember, the more risk factors you have, the greater your chances are for suffering from PAD.

More information about Crozer-Keystone vascular services is available at www.crozerkeystone.org. Click on the “vascular” tab under “Services.”

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