Peripheral Arterial Disease

Your arteries carry blood rich in oxygen and nutrients from your heart to the rest of your body. When the arteries in your legs become blocked, your legs do not receive enough blood or oxygen, and you may have a condition called peripheral artery disease (PAD), sometimes called leg artery disease.

PAD can cause discomfort or pain when you walk. The pain can occur in your hips, buttocks, thighs, knees, shins, or upper feet. Leg artery disease is considered a type of peripheral arterial disease because it affects the arteries, blood vessels that carry blood away from your heart to your limbs. You are more likely to develop PAD as you age. One in 3 people age 70 or older has PAD. Smoking or having diabetes increases your chances of developing the disease sooner.

The aorta is the largest artery in your body, and it carries blood pumped out of your heart to the rest of your body. Just beneath your belly button in your abdomen, the aorta splits into the two iliac arteries, which carry blood into each leg. When the iliac arteries reach your groin, they split again to become the femoral arteries. Many smaller arteries branch from your femoral arteries to take blood down to your toes.

Your arteries are normally smooth and unobstructed on the inside but, as you age, they can become blocked through a process called atherosclerosis, which means hardening of the arteries. As you age, a sticky substance called plaque can build up in the walls of your arteries. Plaque is made up of cholesterol, calcium, and fibrous tissue. As more plaque builds up, your arteries narrow and stiffen. Eventually, enough plaque builds up to reduce blood flow to your leg arteries. When this happens, your leg does not receive the oxygen it needs. Physicians call this leg artery disease. You may feel well and still have leg artery disease or sometimes similar blockages in other arteries, such as those leading to the heart or brain. It is important to treat this disease not only because it may place you at a greater risk for limb loss but also for having a heart attack or stroke.

What are the symptoms?
You may not feel any symptoms from peripheral artery disease at first. The most common early symptom is intermittent claudication (IC). IC is discomfort or pain in your legs that happens when you walk and goes away when you rest. You may not always feel pain; instead you may feel a tightness, heaviness, cramping, or weakness in your leg with activity. IC often occurs more quickly if you walk uphill or up a flight of stairs. Over time, you may begin to feel IC at shorter walking distances. Only about 50 percent of the people with leg artery disease have blockages severe enough to experience IC.

Critical limb ischemia is a symptom that you may experience if you have advanced peripheral artery disease. This occurs when your legs do not get enough oxygen even when you are resting. With critical limb ischemia, you may experience pain in your feet or in your toes even when you are not walking.

In severe peripheral artery disease, you may develop painful sores on your toes or feet. If the circulation in your leg does not improve, these ulcers can start as dry, gray, or black sores, and eventually become dead tissue (called gangrene).

Amputation:
In extreme cases, especially if your leg has gangrene and is not salvageable, your surgeon may recommend amputating your lower leg or foot. Amputation is a treatment of last resort. Vascular surgeons usually only perform it when the circulation in your leg is severely reduced and cannot be improved by the methods discussed already. More than 90 percent of patients with gangrene who are seen by vascular specialists can avoid amputation or have it limited to a small portion of the foot or toes.

~ VascularWeb ~