PERIPHERAL ARTERIAL DISEASE

Peripheral arterial disease (PAD) is narrowing of blood vessels (arteries) supplying the blood flow to the limbs. The narrowing is because of hardening of arteries caused by cholesterol and/or calcium deposits within the arterial wall.

SYMPTOMS

In the initial stages, the disease is not symptomatic. One of the first sign of peripheral arterial disease is difficulty in walking called intermittent claudication. Patients complain of pain in leg on walking with relief from pain on stopping. As the disease progresses, the pain becomes constant even at rest. This further leads to ulcers or gangrene in the legs which is potentially life threatening besides requiring amputation of the affected part.

WHO IS AT RISK?

  1. Patients with known heart disease and stroke. 
  2. Patients with diabetes. 
  3. Chronic Smokers. 
  4. Patients with hypertension. 
  5. Patients with high cholesterol.
  6. Patients with renal failure.

DIAGNOSIS

In the early stages, one of the screening tests is a simple non-invasive test called Ankle Brachial Index (ABI) measurement. This involves measuring blood pressure in the arm and leg simultaneously. Another very useful diagnostic test is an ultrasound scan of the leg arteries – this measures the degree of artery narrowing as well as amount of blood flow in the arteries.  With advanced disease, other non-invasive tests CT or MRI scan can be done.

TREATMENT

One of the first things done in patients with PAD is to control their risk factors well with proper medical management such as controlling diabetes, hypertension, high cholesterol etc. with medication

For significant symptoms, further management options are open surgery or minimally invasive endovascular treatment which is angioplasty and stent placement. Minimally invasive methods of treatment such as angioplasty are now becoming extremely popular as they are as effective as surgery with shorter recovery times. For a significant number of patients, this can be done as a day procedure with discharge from the hospital on the same day.