All organs and tissues in our body need blood to survive; if they do not receive it properly, a condition called “ischemia” occurs, leading to the death of the cells.
Oxygen-rich blood is pumped from the heart into the aorta, the largest artery in our body, which splits into smaller arteries that reach through a dense network of capillaries to each cell. Here, oxygen and nutrients are released.
Circulation is a continuous system that is fundamental to our health and well-being. In some cases, however, it can “get stuck,” as it happens with peripheral artery disease, a condition that can be particularly dangerous and disabling.
What Is Peripheral Artery Disease?
Peripheral artery disease is caused by the deposition of atherosclerotic plaques in the arteries of the lower limbs. These plaques, like limestone deposited on the walls of a pipe, make it difficult for blood to pass through the blood vessel (in this case, it is called “stenosis“). If the situation worsens, the artery may even become completely occluded.
So, when blood passage is reduced, insufficient oxygen reaches the tissues.
The first to be affected are the muscles in motion. This is why the early stage of this condition is called “window shopper’s disease“; precisely because the patient, after a short stretch of walking, is affected by cramp-like pain in the calf or thigh muscles and is forced to stop for a few minutes before resuming walking.
When the situation worsens, there is insufficient blood supply even under resting conditions, leading to severe consequences such as night pain and limb gangrene.
Peripheral Artery Disease: Which Tests to Do?
The first key point in diagnosing peripheral artery disease is to listen to the patient carefully, focusing on the reported symptoms.
These are highly characteristic and will allow for an initial clinical diagnosis. A vascular surgery examination might be carried out, in which the physician can manually feel the pulsation of the arteries in the legs.
A critical diagnostic examination is the Doppler ultrasonography, a non-invasive, painless test. With this method, the specialist can visualize the arteries via ultrasound and assess how the blood flows within them, measuring its velocity and any alterations in flow.
This gives a precise idea of where obstructions are located and their actual extent, and by correlating the results with the symptoms, the physician can assess whether and how intervention is needed.
How Is Peripheral Artery Disease Treated?
The first thing to do is to improve one’s lifestyle to counteract the risk factors, mainly smoking and hypercholesterolemia. Physical activity is imperative; taking long walks on a daily basis is enough for the small peripheral arteries, close to those that may be obstructed, to develop. These constitute true “natural by-passes” that allow for improvement without surgery.
When controlling risk factors is not enough, it will be necessary to ensure that blood flows to the tissues as it should. It is possible to act in several ways, first with appropriate drugs designed to reduce blood cholesterol levels and decrease the risk of vascular thrombus formation.
If this is not enough, blood passage can be improved through endovascular interventions (i.e., without surgical cutting) using balloons that dilate the artery from the inside, associated or not with the placement of vascular stents.
In other cases, surgical intervention will have to be performed either by manually clearing the artery of plaque or by having the blood “skip” the area of occlusion through a new conduit (“by-pass”) reaching the peripheral tissues.
