Peripheral Arterial Disease

What Is Peripheral Arterial Disease - PAD?

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.

Who Has PAD? -- What Are The Signs Of PAD?

• Cramping pains in the legs or hip muscles with walking, that stops during rest or feelings of numbness, weakness or heaviness of the legs with no pain.
• Burning or aching in the feet and toes while at rest, particularly while lying flat.
• Cooling of the skin in specific areas of the legs or feet.
• Color changes in the skin, particularly in the arms or legs.
• Sores (wounds or ulcers) on the feet and toes, especially ones that do not heal.
• No pulses in the feet.
  
  

Who Is At Risk?

• Smoking is the number one risk factor for PAD and will interfere with treatment of the disease. People with PAD should stop smoking completely because even 1 or 2 cigarettes daily can affect treatment.
• Diabetes is a significant risk factor for PAD. People with diabetes should keep strict control of their blood sugar to avoid serious problems resulting from PAD.
• Older age is a predictor for PAD. It occurs more frequently in those 60 years of age or older.
• Family History:  People with a family history of heart disease are at greater risk for PAD.

How Do You Test For PAD?

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