Peripheral artery disease, also known as PAD, occurs when there is
narrowing of the blood vessels outside of the heart. Most
frequently, PAD affects the arteries in the pelvis and legs, but it
can also affect the arteries in the arms, kidneys and stomach, as
well as the aorta, a major blood vessel that comes from the heart
and supplies blood to the rest of the body. PAD in the legs occurs
when the leg arteries become clogged with fatty deposits that can
reduce blood flow to the legs and feet and, if left untreated,
amputation may be necessary in severe cases. PAD can also be a red
flag that the same fatty deposit buildup is happening in blood
vessels elsewhere in your body, putting you at a four to five times
greater risk for having a heart attack or stroke. PAD affects 12 to
20 percent of Americans age 65 or older, yet only one-third of them
have any symptoms, according to the American Heart Association. Even
those who do experience PAD symptoms often fail to mention them to
their doctor, so their PAD is left untreated.
Symptoms of PAD can include leg pain when walking, foot or toe
pain that disturbs sleep, a decrease in body temperature in the
lower leg or foot, sores on legs or feet that are slow to heal, a
change in the skin color of the legs or feet, and slower hair and
toenail growth. If patients experience any of these symptoms, they
should speak with their doctors immediately and ask to be screened
for PAD.
"It is important for patients to discuss any peripheral artery
disease symptoms they may be having with their health care
provider," says Dr. Charles A. Simonton, chief medical officer for
vascular devices at Abbott, a global health care company. "People
often think their chronic leg pain is due to arthritis or just part
of the aging process, so their PAD goes undiagnosed. The earlier we
can diagnosis PAD, the better chance we have of restoring the
patient's blood flow in their legs and avoiding more serious
problems."
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One of the most common tests for PAD is called ankle-brachial
index, or ABI, a simple, non-invasive test that can be done in a
physician's office. In a typical ABI test, the physician uses a
blood pressure cuff to measure the blood pressure in both arms and
ankles at rest and then again after exercise. Specific changes in
the blood pressure between rest and exercise can determine if a
patient has PAD. In addition, other tests may include a review of
your medical history to understand issues such as family history,
diet and smoking habits — all of which can contribute to your risk
of having PAD.
While PAD can become a very serious condition if left untreated,
it also can be successfully treated through a number of methods.
Many patients are helped by simply increasing their exercise and
adopting a low-fat diet. Some patients may need to take medications
to lower blood pressure or cholesterol, or they may need blood
thinners. For stubborn blockages, a balloon catheter may be inserted
through a small incision in an artery to the location of the
blockage and inflated to open the vessel. A stent — a tiny metal
tube — may also be used to hold the artery open. For the most severe
cases, leg-vein bypass surgery or amputation may be necessary.
If you think you could be at risk, speak with your health care
provider about getting screened for peripheral artery disease.
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