Atherosclerosis or hardening and narrowing of arteries can affect the arteries going to the legs. The results of the low blood flow to the legs can range from muscle cramping when walking to poor wound healing with gangrene and eventual loss of legs. This range of disease depends on how severe the narrowings are and how much the blood supply to the leg is decreased. The risk factors for PAD are:
- Bad Cholesterol
- High Blood Pressure
- Family History
P.A.D. develops slowly over many years. In the early stages, most people with P.A.D. have no symptoms. Only about one out of three people with P.A.D. actually feel there is something wrong with their feet or legs. By that time, their arteries may be so clogged or hardened that they are not getting enough oxygen to supply their leg muscles and they may develop non-healing wounds.
Lower-extremity P.A.D. is a serious disease that affects about 8 million Americans. The hardened arteries found in people with P.A.D. are a sign that they are likely to have similar hardening and narrowing of the arteries to the heart and the brain. That is why people with P.A.D. are at high risk for having a heart attack or a stroke.
When the blood flow to the legs is greatly (or severely) reduced, people with P.A.D. may have pain when walking. Fatigue or cramping of your muscles (claudication) in the calf, thigh, hip, or buttock may signal you have PADS. Typically the discomfort is felt after walking a certain distance and goes away with rest. P.A.D. may cause other problems that can lead to amputation. People with P.A.D. may become disabled and not be able to perform their daily activities. As time goes on, they may have a very poor quality of life.
Primary treatment of P.A.D is preventative by stopping smoking, using aspirin or other platelet drugs, cholesterol pills and exercise. This preventative strategy can also reverse some of the more mild early stages of the disease. Treatment currently involves minimally invasive angioplasty and stenting in 80% to 90% of cases. Bypass operations were the blockage is bypassed using an extra leg vein or artificial grafts are an important and durable method of treating P.A.D but are typically reserved for more complex disease.
These life saving steps will help to prevent and control P.A.D.
- Get help to quit smoking and set a quit date now.
- Lower your blood pressure to less than 120/80 mmHg if you have diabetes or chronic kidney disease.
- Lower your LDL (bad) cholesterol to less than 100 mg/dl. If you are at very high risk for a heart attack or stroke, your health care provider may recommend an LDL goal of less than 70 mg/dl.
- Manage your blood glucose to reach an A1C level of less than 7 and practice proper foot care if you have diabetes.
- Talk to your doctor about taking anti-platelet medicines such as aspirin or clopidogrel to prevent clotting.
- Follow a healthy eating plan to control your weight, blood pressure, cholesterol and blood glucose (for diabetes).
- Get regular exercise such as walking for 30 minutes at least 3 or 4 times per week. If you have pain or cramps in your legs, ask your health care provider to refer you to a special PAD exercise program. Also, talk with your provider about using medicines such as cilostazol (pletal) to improve your walking ability.
Angioplasty and Stenting
In some cases of peripheral artery disease, your physician may recommend angioplasty and stenting. This procedure is considered to be minimally invasive in comparison to open surgery. It is most effective for more localized blockages in the larger arteries.
During an angioplasty, your physician inserts a long, thin, flexible tube called a catheter into a small puncture over an artery in your arm or groin.The catheter is guided through your arteries to the blocked area. Once in place, a special balloon, which is attached to the catheter, is inflated and deflated several times. The balloon pushes the plaque in your artery against your artery walls, widening the vessel and increasing blood
flow. In some circumstances, your vascular surgeon may then place a tiny mesh-metal tube, called a stent, into the narrowed area of your artery to keep it open.