What is Peripheral Artery Disease?
Peripheral vascular disease, commonly known as peripheral artery disease, is a condition of the blood vessels that leads to narrowing and hardening of the arteries (atherosclerosis) that supply the legs and feet. This narrowing leads to decreased blood flow, which can injure nerves and other tissues.
Peripheral Vascular Disease: Risk Factors
Peripheral vascular disease occurs when plaque builds up on the walls of the arteries, causing them to narrow and stiffen, meaning they cannot widen to allow greater blood flow when needed. As a result, when the muscles of your legs are working harder (during exercise or walking, for example), they cannot get enough blood and oxygen. Eventually the disease may become so problematic that there is not enough blood and oxygen, even when the muscles are resting.
While this disease typically affects men over age 50, people are at a higher risk if they have a history of:
- Abnormal cholesterol
- Heart disease (coronary artery disease)
- High blood pressure (hypertension)
- Kidney disease involving hemodialysis
Peripheral Vascular Disease: Symptoms
Standard symptoms of peripheral vascular disease include pain, achiness, fatigue, burning, or discomfort of your feet, calves or thighs. These symptoms often appear during walking or exercise and go away after several minutes of rest.
- Initially, these symptoms may appear only when you walk uphill, walk faster or walk for longer distances
- Slowly, these symptoms come on more quickly and with less exercise.
- Eventually, your legs or feet may feel numb when you are at rest. The legs may feel cool to the touch, and the skin may look pale.
When peripheral artery disease becomes more severe, you may experience:
- Pain and cramps at night
- Pain or tingling in the feet or toes (this can be so severe that even the weight of clothes or bed sheets is painful)
- Pain that is worse when you raise the leg and improves when you dangle your legs over the side of the bed
- Skin that looks dark blue
- Sores that do not heal
How is Peripheral Vascular Disease Treated at TriHealth?
First, your doctor will perform a physical exam. During which, he or she may find:
- A whooshing sound with the stethoscope over the artery (arterial bruits)
- Decreased blood pressure in the affected limb
- Loss of hair on the legs or feet
- Weak or absent pulses in the limb
If your case of peripheral artery disease is more severe, your doctor may find:
- Hair loss over the toes and feet
- Painful, non-bleeding sores on the feet or toes (usually black) that are slow to heal
- Paleness of the skin or blue color in the toes or foot
- Shiny, tight skin
- Shrinking calf muscles
- Thick toenails
Blood tests may show high cholesterol or diabetes.
Tests for peripheral vascular disease may include:
- Angiography of the arteries in the legs (arteriography)
- Blood pressure measured in the arms and legs for comparison
- Doppler ultrasound exam of an extremity
- Magnetic resonance angiography or CT angiography
If you are diagnosed with peripheral vascular disease, your doctor may suggest one (or a combination) of the following treatment options:
- Balancing exercises with rest. Walking or doing another activity to the point of pain and alternate it with rest periods. (Over time, your circulation may improve as new, small blood vessels form.)
- Smoking cessation. (Smoking narrows the arteries, decreases the blood’s ability to carry oxygen, and increases the risk of forming clots.)
- Taking care of your feet, especially if you also have diabetes. (Wear shoes that fit properly. Pay attention to any cuts, scrapes or injuries, and see your doctor right away. Tissue heals slowly and are more likely to get infected when there is decreased circulation.)
- Make sure your blood pressure is well controlled
- Reduce your weight, if you are overweight
- If your cholesterol is high, eat a low-cholesterol and low-fat diet.
- Monitor your blood sugar levels if you have diabetes and keep them under control.
Your doctor may recommend or prescribe the following medications to help control peripheral artery disease:
- Aspirin or a medicine called clopidogrel (Plavix), which keeps your blood from forming clots in your arteries.
- Cilostazol, a medication used to enlarge the affected artery or arteries for moderate-to-severe cases that are not candidates for surgery
- Medicine to help lower your cholesterol
- Pain relievers
Surgical intervention we offer at TriHealth for treating peripheral artery disease includes:
If you have a vascular condition causing artery blockages in the legs, your doctor may recommend drug releasing stents as a treatment option.