Peripheral Artery Disease (PAD) is a common circulatory problem where narrowed arteries reduce blood flow to the limbs, usually affecting the legs. It occurs when atherosclerosis (the build-up of fatty deposits or plaques) narrows the arteries, leading to reduced blood flow, which can cause pain and other symptoms.

Causes

  • Atherosclerosis: The primary cause of PAD, where fatty deposits build up on the walls of the arteries, reducing blood flow.
  • Blood vessel inflammation: May cause narrowing of the arteries.
  • Injury to limbs: Can damage blood vessels and reduce blood flow.
  • Radiation exposure: Previous radiation therapy can damage blood vessels.
  • Rare conditions: Including blood vessel abnormalities or muscle and ligament problems.

Risk Factors

  • Smoking: One of the most significant risk factors for PAD.
  • Diabetes: Increases the risk due to its impact on blood vessels.
  • High blood pressure: Can damage arteries over time.
  • High cholesterol: Contributes to plaque buildup in the arteries.
  • Age: Risk increases with age, especially after 50.
  • Family history: Genetic predisposition to atherosclerosis or cardiovascular diseases.
  • Obesity: Excess weight increases the risk of developing PAD.
  • Sedentary lifestyle: Lack of physical activity contributes to poor circulation.

Symptoms

  • Intermittent claudication: Pain, cramping, or heaviness in the legs or buttocks during physical activity, which improves with rest.
  • Leg numbness or weakness.
  • Coldness in the lower leg or foot.
  • Sores or wounds on the toes, feet, or legs that do not heal well.
  • Change in colour of the legs (pale or bluish skin).
  • Decreased pulse or weak pulse in the legs and feet.
  • Erectile dysfunction in men, particularly when associated with atherosclerosis.

Diagnosis

  • Ankle-Brachial Index (ABI): A simple test that compares the blood pressure in the ankle with the blood pressure in the arm to detect any reduction in blood flow.
  • Doppler Ultrasound: Measures the blood flow in the blood vessels and can identify blocked or narrowed arteries.
  • Angiography: Uses imaging techniques (CT, MRI, or X-ray) to visualize blood flow in the arteries and detect blockages.
  • Blood tests: To check for underlying conditions such as diabetes, cholesterol levels, and other risk factors.

Treatment

  • Lifestyle changes: Quitting smoking, adopting a healthy diet, exercising regularly, and managing weight.
  • Medications:
    • Antiplatelet agents: Such as aspirin or clopidogrel to reduce the risk of blood clots.
    • Cholesterol-lowering drugs: Such as statins to manage cholesterol levels.
    • Medications for blood pressure and diabetes management.
    • Cilostazol or pentoxifylline: To improve walking distance and reduce symptoms of claudication.
  • Procedures and Surgeries:
    • Angioplasty and stenting: A minimally invasive procedure to widen narrowed arteries and place a stent to keep them open.
    • Bypass surgery: Creates a detour around the blocked artery using a graft.
    • Atherectomy: Removes plaque build-up from the artery.
  • Supervised exercise programs: Shown to be effective in reducing symptoms and improving walking distance.

Complications

  • Critical limb ischemia: A severe condition where blood flow to the extremities is severely reduced, leading to pain, sores, or infections.
  • Heart attack and stroke: Due to atherosclerosis affecting not only the peripheral arteries but also those supplying the heart and brain.
  • Amputation: In severe cases where blood flow is severely restricted, and tissue death occurs.

Early diagnosis and treatment are essential to manage symptoms, improve quality of life, and prevent serious complications. Regular check-ups and monitoring are important, especially for those with risk factors for PAD.

At Precious Medical Group (PMG), we are here to assist you further. Please feel free to contact us for any enquiry.