The gradual accumulation of fatty material (atheroma) within the artery wall causes hardening and narrowing of the arteries, a condition known as atherosclerosis. This results in less nutrition for the parts of the body that are supplied by the affected arteries. The manifestation depends on which arteries are affected. For example, when the arteries that supply blood to the heart are affected, angina pectoris or a heart attack can occur. sources from 291bet When the arteries that supply blood to the legs are affected, peripheral arterial disease occurs. How common is the disease? It becomes more common as one ages, and by age 70, about 20 percent of the population has peripheral arterial disease. Interestingly, almost 75% of people with the disease do not experience symptoms in the early stages. sources from medcom Diagnosis is critical, as people with peripheral artery disease also have a six to seven times greater risk of having a heart attack or stroke.
What are the symptoms of peripheral artery disease? The predominant symptom is pain in the calf, thigh, or buttock muscles when walking or exercising. Slowing down allows the pain to go away. As the disease progresses, the pain may become continuous. The skin on the leg becomes shiny and may change color. Sometimes foot or toe ulcers can develop. Gangrene of the leg can develop with further progression of the disease.
What Causes Peripheral Artery Disease? Smokers have a 20 times higher risk of peripheral arterial disease than non-smokers. A high-fat diet, lack of physical activity, high blood pressure, and diabetes accelerate the development of the disease.
How is the condition diagnosed? The typical history in conjunction with a clinical examination is helpful in making a diagnosis. The relationship between the blood pressure measured in the ankle and that of the arm, called the ankle brachial index (ABI), is very useful as a screening test to identify people with peripheral arterial disease. Further tests, such as a Doppler ultrasound and angiography of the arteries in the leg, may be required to find out where the narrowing of the artery is and how severe it is.
What treatments are available? You must stop smoking immediately. A low-fat diet, weight loss, and regular physical activity are encouraged. People with high blood pressure and diabetes need to make sure their disease is well controlled. Foot care is an important aspect of treatment. Feet should be regularly inspected for skin changes, properly washed and dried every day, and well-fitting shoes should be worn. Medications are generally not very helpful in reducing symptoms, although cilostazol and pentoxifylline are believed to improve walking distance. Aspirin and cholesterol-lowering medications are usually given.
If symptoms interfere with normal activities, intervention should be considered. The narrow artery can be opened with an inflatable balloon that is passed through an artery in the groin under local anesthesia, the procedure is known as peripheral angioplasty. A cylindrical wire mesh tube, called a stent, is placed in the narrow segment of the artery to keep the diseased artery open. The procedure is painless and only requires a couple of days of hospitalization. In some cases, surgery to avoid the blockage may be the only option. This is a major operation under general anesthesia that requires a longer hospital stay. The graft used for bypass can be artificial or one of the patient’s veins can be used for this purpose.
Leg amputation is a last resort and is rarely necessary if medical advice is followed and proper precautions are taken early on.