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The arteries are the blood vessels that carry the blood from the heart to all the areas of the body. Peripheral arterial disease (PAD) is a condition in which fatty deposits (called plaque) build up along the walls of the arteries that carry blood to the arms and legs. This is also known as arteriosclerosis or hardening of the arteries. As plaque develop and thicken, the arteries slowly narrow and may even become blocked that will significantly affect blood circulation especially in the legs and feet. These are the large vessels where the pulse can be felt in the extremities. In contrast, diabetes is a microcirculation disease affecting the small vessels that supply oxygen to the tissues. In 50% of diabetic patients, there is the complication of peripheral arterial disease that must be treated to prevent the development of a limb threatening infection. According to the Peripheral Arterial Disease Coalition, most patients with PAD exhibit symptoms but 20-50% of patients with PAD have no symptoms.
The first step is to perform a non-invasive vascular examination. The two main PAD tests are by use of measuring blood pressures or imaging the blood vessels with ultrasound technology. In measuring the blood pressure, this is a simple test done by placing blood pressure cuffs about the leg at different levels to measure the blood pressure and obtain an image of the pulse wave form. This will give the Podiatrist an excellent indication if there is evidence of PAD. Your foot doctor can then advise you if you need treatment or if further testing is necessary. Further testing would involve a angiogram by a Vascular Surgeon or Interventional Radiologist.
Sources: American Heart Association., Center for Disease Control and Prevention, National Institute of Health, Society of Cardiovascular and interventional Radiology, Vascular Disease Foundation, World Health Organization
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