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Understanding your risk
People at the highest risk of PAD are over the age of 50, with high blood pressure, high cholesterol, diabetes, and those who have suffered a stroke. Additionally, men are also at a higher risk of PAD than women. PAD occurs when the arteries become narrowed by a buildup of plaque – including cholesterol, fatty deposits, calcium, and other substances in the blood. Blocked arteries can prevent oxygen-rich blood from reaching the muscles when the muscles need it most. This lack of oxygen causes pain. PAD can increase your risk of heart attack and stroke. But the good news is that PAD can be easy to diagnose and is treatable.
Knowing the symptoms
PAD may cause a dull, cramping pain in the legs, hips or buttocks when you exercise that stops when you rest. This is a classic PAD symptom called claudication. Symptoms appear as a result of blocked arteries in these areas. Other symptoms of PAD include:
- Numbness or tingling in the legs, feet, or toes
- Changes in skin color (pale, bluish, or reddish coloration)
- Cool skin (for example, in the legs, feet, arms, or hands)
- Impotence
- Infections or sores that do not heal
It’s important to note that people with PAD may have no symptoms at all.
Reaching a diagnosis
The most common test for PAD is the ankle brachial index (ABI), a painless exam that uses ultrasound images to measure blood pressure in the feet and arms. The ABI compares the blood pressure in your legs and arms using a blood pressure cuff. If the pressures are different, it could mean you have PAD. If the ABI shows you have PAD, your doctor may order other tests to help identify the location and seriousness of the blocked artery. Tests for PAD include:
Duplex Doppler ultrasound
Uses sound waves to create a picture of the arteries. This type of ultrasound can also show if blood is flowing smoothly through the arteries.
Magnetic resonance imaging (MRI)
Uses radio waves in a magnetic field to create a flat or three-dimensional picture of the arteries. If you have a pacemaker or implantable cardioverter defibrillator (ICD), be sure to check with your doctor before having an MRI or any other medical procedure.
Angiography
Uses a special dye injected into the artery through a small tube called a catheter. The dye shows up on x-rays and helps determine which arteries are narrowed or blocked. For this test, you will be given a local anesthetic.
Computerized tomography angiography (CTA)
Uses an injectable dye along with x-rays to view the blood vessels from different angles. The computer analyzes the x-rays to form a three-dimensional picture of the arteries.
Treating PAD
After testing and diagnosis, your doctor may decide to treat your blockage with a medical procedure. The following are the most common procedures to treat PAD:
Angioplasty
During an angioplasty procedure, a catheter with a balloon is passed through the blocked artery. Once inflated, the balloon compresses the plaque against the wall of the artery, allowing the blood to flow freely.
Stent implantation
A stent implantation uses a tiny mesh tube, called a stent. The stent is placed in the artery to help hold it open and increase blood flow.
Atherectomy
An atherectomy uses a special catheter to gently shave and remove plaque from the arteries to increase blood flow.
Endarterectomy
During an endarterectomy, a special catheter removes plaque buildup in the lining of the artery to improve blood flow in your carotid artery and reduce risk of stroke.
Bypass surgery
Bypass surgery involves taking a healthy blood vessel from another part of the body to create a detour and allow blood to flow around a blocked artery. A small, man-made tube can also be used in place of taking a blood vessel from the patient.
