Peripheral Arterial SyndromeSpecialist

Peripheral Arterial Disease (PAD) can affect all arteries of your body, most commonly the lower limbs, causing pain when walking or, less often, neck pain. It is a type of peripheral vascular disease that results in narrowed or blocked arteries, leading to reduced blood flow to the limbs, especially the legs. PAD is a common condition affecting millions of people worldwide and is a significant cause of disability and even death.

Peripheral Arterial Disease is often the culprit behind strokes and acute limb ischemia, which are both very serious and life-threatening conditions.

What Is Atherosclerosis & How Does It Develop?

When we discuss Peripheral Arterial Disease, atherosclerosis deserves an honorable mention, as PAD itself is most commonly caused by the latter. Atherosclerosis occurs when our arteries become besieged by plaque buildup, which are sticky fatty deposits responsible for gradually blocking the inner walls of our arteries.

Atherosclerosis is most often associated with heart disease, but it can affect all arteries of the body, developing in a similar way. The condition begins with damage to the endothelium – the inner, delicate layer of the artery. It occurs as a result of blood flow disorders or an ongoing inflammatory reaction. Subsequently, the above-mentioned deposits, composed of multiple substances and cells, such as fat, accumulate in the inner wall of the artery, gaining the name atherosclerotic plaques.

When the conditions are favorable, they will enlarge over time and can possibly burst, leading to the detachment of their fragments and the formation of blood clots.

The development of atherosclerosis leads to the narrowing of the lumen of your vessel, the tubular opening through which your blood flows. As a result, it reduces blood flow and leads to hypoxia (reduced oxygen levels) – initially only when its demand is increased, and then, as plaques grow in size, also at rest.

The final stage of the disease is the complete closing of the vessel, often resulting from large plaque deposits or extensive damage to the artery.

Symptoms of Peripheral Arterial Syndrome

Many people with Peripheral Arterial Syndrome have no symptoms or only mild manifestations of the disease, while some individuals experience leg pain and cramping, especially when walking or climbing stairs. This pain is called intermittent claudication and occurs because the leg muscles are not getting enough blood flow during exercise. The pain usually goes away after resting for a few minutes.

As PAD progresses, the symptoms can become more severe, including:

• Pain in the legs or feet at rest, especially at night.
• Wounds or sores on the legs or feet that heal slowly or not at all.
• Coldness or numbness in the legs or feet.
• Weakness or loss of function in the legs or feet.

Diagnosis of Peripheral Arterial Syndrome

PAD can be diagnosed with a physical exam and a few simple tests, including:

• Ankle-brachial index (ABI) test: This test measures your ankle’s blood pressure versus the blood pressure in your arm to determine if there is reduced blood flow to the legs.
• Doppler ultrasound: This diagnostic test utilizes sound waves to create images of the blood flow in your arteries.
• Angiography: This test involves injecting dye into your arteries and taking X-rays to see how the blood flows through them.

Treatment of Peripheral Arterial Syndrome,

The treatment of PAD usually involves lifestyle changes and medications to reduce the risk of complications. Lifestyle changes may include:

• Quitting smoking: This is the most critical step in treating PAD.
• Exercise: Regular exercise, especially walking, can improve blood flow to the legs and reduce symptoms.
• Healthy diet: A diet low in saturated fats with an increased intake of fruits, vegetables, and whole grains can help reduce cholesterol and improve overall health.

Medications may include:

• Cholesterol-lowering drugs: Statins can reduce the amount of cholesterol in the blood and slow the progression of atherosclerosis.
• Blood-thinning drugs: Aspirin and other blood-thinning drugs can help prevent developing blood clots in the narrowed arteries.
• Medications for blood pressure and diabetes: These medications can help control blood pressure and blood sugar levels, reducing the risk of complications. Managing your chronic conditions with your doctor is the best approach in both the prevention and treatment of peripheral arterial disease and similar by-products of atherosclerosis.

In some cases, more invasive treatments may be necessary, such as angioplasty or bypass surgery. Angioplasty involves using a balloon to widen the narrowed artery, while bypass surgery involves creating a new blood vessel to bypass the blocked area.