Peripheral Arterial Disease (PAD)
Approximately 8-12 million Americans are currently
affected by a condition known as peripheral arterial
disease (PAD). Though under-diagnosed, this condition
is quite common, especially in older men aged
50 plus. According to the U.S. Department of
Health and Human Services, peripheral arterial
disease affects about 1 in 20 people over the
age of 50, but only a quarter of those suffering
from PAD are currently receiving treatment.
About the Disease
Peripheral
arterial disease is a condition in
which fatty plaque builds up in the (peripheral)
arteries that supply blood to the extremities,
including the legs and, in more rare cases, the
arms. Over time, these buildups can potentially
increase to the point where they completely block
important blood vessels. Extreme cases involving
the blockage of a vital artery can lead to the
loss of a limb or even death.
People are at higher risk for PAD if they have:
- personal or family history of heart disease
or stroke
- diabetes
- smoking
- hypertension
- kidney disease involving hemodialysis
If you have poor circulation of the blood in
your legs, you may have also reduced blood flow
to your heart or brain, which can lead to heart
attack or stroke. In fact, people with PAD are
at a greatly increased risk of heart attack or
stroke and death.
Symptoms can vary between patients but, with
the help of a doctor, peripheral aterial disease
can usually be controlled with treatment.
Diagnosis and Evaluation
The initial evaluation involves the non-invasive
diagnosis of the level and extent of the disease.
As common forms of rehabilitation, exercise and
medical therapy may signifigantly improve pain-free
walking distance.
Medical Therapy
If diagnosed with PVD, your first step is to talk
with your physician about creating a treatment
plan that is appropriate for you. Treatment of
peripheral vascular disease generally focuses
on the relief of symptoms and self-care to improve
circulation. In some cases, medical therapy may
be required to control the disorder, including
pain relievers, blood thinners, and medications
to enlarge or dilate the affected artery(ies).
Minimally Invasive and Surgical Treatment
Surgery is often performed in severe cases in which PAD affects the patient's
ability to work or pursue essential activities. Surgery may consist of removing
the lining of the artery, or repairing or replacing the vessel; most commonly,
bypass surgery is performed, using a vein or synthetic graft. Alternatives to
surgery may include minimally invasive procedures such as balloon angioplasty,
sometimes followed by stent implantation, or other treatments.
Self-care
Self-care is an important component of treatment
for persons with peripheral aterial disease.
For patients experiencing the effects of PAD,
exercise must be balanced with rest. Walking
or other activities, performed to the point
of pain and alternated with rest periods, is
also often recommended. Over time, circulation
improves because of the development of small,
new blood vessels.
A healthy lifestyle and frequent check-ups are
the best protection from peripheral aterial disease
and its potentially devastating results. It is
important for patients with PAD to avoid smoking,
because it constricts arteries and decreases
the blood's ability to carry oxygen, which
in turn increases the risk of forming new clots.
Finally, it is important to wear shoes that fit
and pay attention to any cuts, scrapes or injury.
If there is decreased circulation caused by PAD,
the skin will take longer to heal.
If you are experiencing the above symptoms or
feel that you might be at risk due to certain
risk factors, see your doctor immediately. If
left untreated, PAD can lead to gangrene, an
infectious condition that may necessitate amputation.
Patients with PAD also have a higher risk of
death from a stroke or heart attack due to the
clotting of blood vessels caused by the disease.
Research Studies
Researchers at the University of Pennsylvania
Health System are investigating several therapies
to improve lifestyle and longevity of patients
with PAD. Speak to your doctor to learn more about
research studies.
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