Peripheral Artery Disease

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KEY POINTS

• Peripheral artery disease is narrowing or blockage in the blood vessels in your pelvis, arms, or legs.
• Eating a healthy diet, exercising, not smoking, and keeping your blood pressure, blood sugar, and cholesterol at healthy levels may help.
• Treatment may include taking medicines or having a procedure to open blood vessels and improve blood flow.

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What is peripheral artery disease?

Peripheral artery disease (PAD) is a disease of the blood vessels, especially the ones that bring blood to the pelvis, arms, or legs. Blockage of these arteries can prevent blood flow to these areas.

What is the cause?

Fatty deposits called plaque may build up in blood vessels and make them narrower. The narrowing decreases the amount of blood flow to the body. Small pieces of plaque may break off from the wall of a blood vessel and completely block a smaller blood vessel. PAD happens when the clogged or blocked arteries cannot provide enough blood and oxygen for the body.

Several factors can increase your risk of PAD:

• Smoking
• Heart disease
• Diabetes
• High levels of LDL (bad) cholesterol or triglycerides
• High blood pressure
• Family history of heart disease
• Being overweight
• Lack of exercise

What are the symptoms?

Symptoms may include:

• Pain, cramping, or weakness in your legs, arms, or hands (these symptoms may occur when you exercise and go away when you rest)
• Loss of feeling in the hands, legs, feet, or toes
• Wounds on the legs or feet that heal slowly or don’t heal
• Cold feet or hands
• Erectile dysfunction

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you.

Tests to find blocked arteries may include:

• Angiogram, which is a series of X-rays taken after your healthcare provider injects contrast dye into your blood vessels to show the walls of the arteries and any blockage
• Ultrasound, which uses sound waves to show pictures of the arteries
• Ankle-brachial index, which uses blood pressure cuffs on the arms and legs to check blood flow

How is it treated?

Your healthcare provider may recommend changes in your lifestyle. Depending on your symptoms, your provider may also prescribe medicine to:

• Try to prevent blood clots
• Relax the blood vessels
• Lower cholesterol
• Help keep your blood pressure in a normal range
• Control your blood sugar if you are diabetic

If your symptoms cannot be controlled or they keep you from doing your normal activities, you may need a balloon angioplasty or bypass surgery.

• A balloon angioplasty opens the blood vessel and improves blood flow. A metal mesh device called a stent is usually left in the artery to help keep the blood vessel open.
• Bypass surgery uses blood vessels from other parts of the body, or manmade material, to make a new path around a blocked area.

If your disease is serious and bypass surgery and angioplasty are not recommended for you, your foot or leg may need to be removed (amputated). Amputation is usually necessary if you have so little blood flow that the skin and other tissues die and you are at risk for life-threatening infection. Amputation is a last resort, but if peripheral vascular disease is not controlled, it is a possible result.

PAD can often be slowed or stopped if it is diagnosed early and the risk factors are controlled. Otherwise, it is a disease that will get worse unless you get treatment and do things to prevent plaque formation.

How can I take care of myself?

If you have peripheral artery disease, there are things you can do to take care of yourself now and prevent problems in the future.

• Follow your healthcare provider’s directions for taking your medicine. Make sure you know how and when to take your medicine. Don’t take more or less than you are supposed to take.
• Quit smoking if you are a smoker. One of nicotine's effects is narrowing and spasm of the arteries. Each cigarette you smoke decreases blood flow as the inhaled nicotine circulates in your blood. It can cause a blood clot, which could bring on a heart attack or stroke.
• Make changes in your diet to help control cholesterol. For example, lower the amount of saturated and trans fats and cholesterol in your diet. Eat more whole grains, fruits, and vegetables.
• Keep good control of your blood sugar if you have diabetes.
• Get more exercise according to your healthcare provider’s recommendations. Exercise can help you improve and keep good blood flow. Your provider may recommend an exercise program for you. When you are exercising, stop and rest if you have too much pain in your legs. Start walking again when the discomfort has gone away.
• Try to keep a healthy weight. If you are overweight, lose weight.
• Take care not to hurt the affected legs or arms. Injuries will heal much more slowly. To prevent infection of the feet, inspect and care for them daily. If you have corns or calluses, get help from your healthcare provider or a podiatrist (foot specialist) to care for them safely.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What can I do to help prevent peripheral artery disease?

You can help prevent this disease with a heart-healthy lifestyle:

• Get your blood pressure, blood sugar, and cholesterol levels checked regularly. Make sure you know what to do to keep them in a healthy range.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.

Taking a low-dose aspirin every day may help prevent a heart attack or stroke. Not everyone should take aspirin. Ask your healthcare provider if you should take aspirin and if so, how much to take.

Talk to your healthcare provider about your personal and family medical history and your lifestyle habits. This will help you know what you can do to lower your risk for peripheral artery disease.