PAD is a chronic disease in which blockage builds up in the arteries to the legs. This buildup typically occurs gradually. It is more common in older people. Smoking, high blood pressure, high cholesterol or triglyceride, diabetes, kidney failure and obesity increase your risk for PAD.
Symptoms
- Fatigue or cramping of muscles while walking
- Pain in toes or feet while resting
- The wound on toes or feet
Causes
The causes of PAD include smoking, high cholesterol or high triglycerides, high blood pressure, diabetes, kidney failure, and obesity.
Diagnosis
- An initial diagnostic test for PAD is the ankle-brachial index (ABI) involves taking a blood pressure reading at the ankle and comparing it to that in the arm.
- Additional supportive testing like TBI or oxygen readings around the wound may be done.
- An Arterial Doppler study can show the presence of disease.
- Typically an angiogram (CT / MRI or conventional) is done to determine where in the arteries plaque has built up to assess treatment options.
Treatments
PAD is usually treated by aggressively managing the risk factors with lifestyle changes and medication. This includes quitting smoking, controlling blood pressure and cholesterol, controlling diabetes, and losing weight. In addition, an exercise program, if followed faithfully, can significantly improve the symptoms of PAD in many cases.
If PAD is causing serious symptoms, further treatments such as balloon angioplasty, stent placement, or surgical bypass can be very effective in improving the blood flow to the affected leg.
Health tips
- Stop smoking
- Exercise regularly
- Take prescribed medications as recommended to control high blood pressure, high cholesterol or triglycerides, diabetes, and kidney failure
- Lose weight to decrease the amount of work your muscles need to do when you walk
- Eat a balanced, low-sodium, low-fat diet
International Publications on Arterial Disease
- Peak systolic velocity ratio derived from quantitative vessel analysis for restenosis after femoropopliteal intervention: a multidisciplinary review from Endovascular Asia. July 2019. Cardiovascular Intervention and Therapeutics 35(1):1-10. DOI: 10.1007/s12928-019-00602-z
- Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial. June 2018.The Lancet 391(10137):2325-2334.DOI: 10.1016/S0140-6736(18)30832-8
- Contemporary critical limb ischemia: Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care. April 2018. Cardiovascular Intervention and Therapeutics 33(4 Suppl). DOI: 10.1007/s12928-018-0523-z
- Vascular Disease in Asia & India- in need of a paradigm shift. Indian Journal of Vascular & Endovascular Surgery.2017 4(4):143
- Non traumatic acute limb ischemia-presentation, evaluation and management. Indian Journal of Vascular& Endovascular Surgery 2017. 4(4) 192-7
- Surgical and endovascular treatment of occlusive aortic syndromes. J Cardiovasc Surg. (Torino). 2013 Feb;54 (1 Suppl 1):55-69.
- Acute thrombosis of abdominal aortic aneurysm presenting with lower limb ischaemia. ANZ J Surg. 2011 Dec;81(12):945-6
- Do Doppler waveforms at the common femoral artery accurately predict iliac stenosis? Ir J Med Sci. 2010 Jul 27.
- An audit of foot infections in patients with diabetes mellitus following renal transplantation. International Journal of Lower Extremity Wounds. 2004 Sep;3(3):157-60
