What is Peripheral Arterial Disease?

Peripheral arterial disease refers to obstruction and narrowing of important arteries in the body. Cholesterol and other insoluble fatty deposits can build up in the blood over time, attaching to arterial walls and blocking blood flow to the legs, arms, and internal organs. In most cases, peripheral arterial disease first targets the arteries that supply the legs, but over time other vital vessels can be affected. Heart attacks and other severe complications can usually be avoided with early diagnosis, healthy lifestyle changes, and cholesterol-lowering medications.

Plaque buildup in the arteries, known as atherosclerosis, occurs when cholesterol clings to the sides of vessels and hardens into place. As a result, blood flow is restricted and the heart has to work harder to supply the extremities. Several genetic and environmental factors can contribute to atherosclerosis and resulting peripheral arterial disease. Smoking, obesity, high blood pressure, and diabetes are the most significant risk factors, and many people have a familial history of the disorder. Peripheral arterial disease is most commonly seen in patients over the age of 50.

Symptoms do not usually become noticeable in the earliest stages of peripheral arterial disease, and the condition often goes unnoticed until it has caused significant damage to arteries. Common early symptoms include cramps and feelings of weakness in the legs, especially following physical activity. As blood flow is further disrupted, one or both legs may become numb, slightly blue-tinted, and cold. Pain and weakness tend to increase as the condition progresses. If other atherosclerosis begins to affect other arteries, the risk of heart attack or stroke greatly increases.

A doctor can diagnose peripheral arterial disease by conducting a thorough physical examination and asking about a patient's medical and family history. X-rays, computerized tomography angiography scans are used to identify the location and severity of arterial constriction and blood clots. In addition, blood samples are usually taken and analyzed to measure cholesterol levels. Once a diagnosis has been made, the physician can determine the best course of treatment.

When symptoms are mild and the disease does not appear to present an immediate health risk, a patient may simply be instructed to get more exercise, quit smoking, and maintain a healthier diet. Medications may be prescribed to regulate blood pressure and help lower cholesterol. If a patient has diabetes, he or she may need to start or adjust an insulin regimen.

If arterial constriction is already causing clots, a procedure called an angioplasty may be required. A surgeon carefully scrapes away loose plaque and inserts a balloon into the narrow artery. The balloon is inflated to expand the cavity, and a stent is put into place to hold the walls open. Bypass surgery is considered a final option if an artery is too damaged to hold a stent.