Definition

Peripheral artery disease (also called peripheral arterial disease) is a common condition in which there is a buildup of fatty deposits in the arteries causing reduced blood flow to the legs, causing them to be unable to keep up with demand. This in turn causes symptoms such as leg pain when walking (intermittent claudication).

Intermittent claudication symptoms include muscle pain in the legs or arms that's triggered by physical activity, such as walking, but disappears after a few minutes’ rest. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is the most common location.

Peripheral artery disease is also likely to be a sign of a more extensive accumulation of fatty deposits in the arteries that can reduce blood flow even to the heart and brain. Eating a healthy diet, exercising regularly and quitting smoking are all factors that can help successfully treat the condition.

 

Symptoms

Many individuals with peripheral artery disease have mild or no symptoms. Some may develop a painful ache in their legs when they walk (intermittent claudication). Peripheral artery disease symptoms include:

  • Muscle pain in the hip, thigh or calf muscles after physical activity
  • Leg numbness or weakness
  • Coldness in the lower leg or foot
  • Discoloration of the legs
  • Decreased hair growth on the feet and legs/ hair loss
  • Decreased toenail growth
  • Shiny skin on the legs
  • Sores on toes, feet or legs
  • No pulse or weak pulse in the legs or feet
  • Erectile dysfunction in men

 

 

Causes

Peripheral artery disease is often caused by atherosclerosis. In atherosclerosis, the buildup of fatty deposits in the artery walls reduce blood flow to the limbs. The fatty deposits, called atheroma, are made up of cholesterol and other waste substances. Although the heart is usually the focus of discussion of atherosclerosis, this disease can and usually does affect arteries throughout your body. Less commonly, the cause of peripheral artery disease may also be:

  • Inflammation of blood vessels
  • Injury to the limbs
  • Irregular features of the ligaments or muscles
  • Radiation exposure

 

Risk factors

Factors that increase the risk of developing peripheral artery disease include the following:

·         Aging (after 50 is most common)

·         Smoking

·         Being overweight

·         Having diabetes

·         Having high blood pressure

·         Having high cholesterol

·         Having a family history of peripheral artery disease

·         Having high levels of homocysteine (a protein component that helps build and maintain tissue)

 

 

 

 

Complications

Possible complications that can arise if the peripheral artery disease is caused by a buildup of fatty deposits in the blood vessels (atherosclerosis) include:

·         Critical limb ischemia: A condition that begins as open sores or an infection on the feet or legs and progresses to cause tissue death.

·         Stroke and heart attack

 

 

Treatment

Treatment for peripheral artery disease has two major goals: to manage symptoms, such as leg pain and to stop the progression of atherosclerosis throughout the body in order to reduce the risk of a heart attack and stroke. Typically, lifestyle changes such as quitting smoking and maintaining a healthy diet can help accomplish these goals. If additional medical treatment is required, a doctor might recommend:

  • Certain medications which can help:

–  lower cholesterol levels and reduce the risk of a heart attack and stroke

– reduce high blood pressure and reach a targeted level of 140/90

– keep blood sugar levels under control (especially significant for individuals with diabetes)

– prevent blood clots

-increase blood flow to the limbs and provide symptom relief

 

 

 

 

 

In some cases, angioplasty or surgery may be necessary to treat peripheral artery disease that's causing intermittent claudication:

·         Angioplasty: A procedure that involves the insertion of a small hollow tube (catheter) through a blood vessel to the affected artery. The tube has a tiny balloon on the end. When the tube is in place, the doctor inflates the balloon to push the fatty deposits outward against the wall of the artery. This widens the artery and restores blood flow.

 

·          Bypass surgery: Surgery that involves redirection of a  blood vessel around areas of narrowing in order to "bypass" the blockages and restore blood flow to the heart muscle.

·         Thrombolytic therapy: The use of a clot-dissolving drug into the artery at the point of the clot to break it up.

 

Prevention

A few recommendations for preventing claudication include maintaining a healthy lifestyle by: 

  • Eating a healthy diet (low in saturated fat)
  • Maintaining a healthy weight
  • Exercising regularly
  • Keeping blood sugar levels in good control
  • Keeping cholesterol and blood pressure levels down
  • Quitting smoking