Peripheral Arterial Disease (PAD)

About Peripheral Arterial Disease

PAD is a result of build-up of plaque in the arteries over time causing narrowing and occlusion of the arteries, usually in the leg and pelvis. Plaque is made up of cholesterol, calcium, fat and other things found in the blood that build up over time and restrict blood flow. 12% of the people in the U.S. suffer from claudication and 20% of people over 70 suffer from a condition called claudication. Claudication is pain/aching or fatigue in the muscles with exertion that resolves with rest. It results from a lack of oxygen/blood to the muscles with exertion when more oxygen/blood is needed. Symptoms resolve with rest because the oxygen/blood demand decreases. PAD starts off slowly but if left untreated can progress to pain at rest, skin ulcers, and even loss of limb.

Symptoms

  • Pain, cramps, achiness in the buttocks, thigh, or calf while walking that resolves at rest.
  • Other symptoms can include tiredness or burning sensation.

 

Risk Factors

  • Age
  • Diabetes
  • Obesity
  • Smoking
  • High blood pressure
  • High Cholesterol
  • Family History

Diagnosis

For complete workup and diagnosis, a comprehensive history and physical should be performed to evaluate for symptoms and identify risk factors. This is followed by medical imaging. Imaging include: Ultrasound (ABI and duplex), CT angiography, MR angiography, and Angiogram.

Treatment Options

  • Lifestyle Changes and Medical Therapy
    • Walking program
    • Medication to manage cholesterol, blood pressure and diabetes control
    • Smoking cessation
    • Healthy diet
    • Preventative medications such as aspirin
  • Minimally Invasive Procedures
    • Angioplasty (balloon dilatation)
    • Stenting
    • Atherectomy
  • Surgical option with bypass grafting