Peripheral artery disease (PAD) is caused by plaque buildup in the arteries, leading to restricted blood flow and nerve and tissue damage. Symptoms include pain, numbness, and tingling in the legs and feet. Treatment options include medication, surgery, and lifestyle changes, with severe cases potentially requiring amputation. Complications can include gangrene, blood clots, and heart disease.
Atherosclerosis obliterans, or peripheral artery disease (PAD), is a medical condition that negatively affects blood vessels and circulation in a person’s lower extremities and can contribute to nerve and tissue damage. Caused by a narrowing or hardening of the artery walls, atherosclerosis obliterans can lead to serious complications. Atherosclerosis obliterans can be treated with medications, surgery, or lifestyle changes, depending on the severity of the disease presentation and the individual’s overall health.
Peripheral artery disease results from a hardening of the arteries caused by plaque buildup. As plaque builds up, arteries narrow and blood flow becomes more and more restricted. By targeting the arteries supplying the legs and feet, PAD can work the muscles in these areas twice as hard, whether the individual is in motion or at rest. Individuals with a history of smoking, high cholesterol, or stroke may be more susceptible to developing PAD. Additional conditions that can contribute to the development of atherosclerosis obliterans can include diabetes, high blood pressure, and heart disease.
Individuals with PAD may experience a gradual onset of signs and symptoms of poor circulation. Initially, symptoms may only occur when the person participates in activities that force the leg muscles to work harder than normal, such as walking uphill or at a brisk pace. Over time, symptoms may come on more quickly, even if the individual does not exercise as much as when the first signs first appeared. While resting, the individual may notice that his or her feet become tingly or numb and are pale or cold to the touch. As symptoms progress, the individual may develop moderate to severe chronic pain in the legs and feet.
Atherosclerosis obliterans can be diagnosed through the administration of a series of tests. During an initial exam, a doctor may check the affected limb for a weakened pulse and low blood pressure. When a stethoscope is applied to the artery, blood flow may seem abnormal, a condition known as an arterial murmur. Those whose PAD has progressed may show shrunken calf muscles or have a bluish tinge to the skin, known as cyanosis, which can be discovered during a physical exam. Diagnostic tests may include magnetic resonance angiography (MRA), computed tomography (CT) angiography of the affected area, and Doppler ultrasound.
Treatment for PAD may include the use of over-the-counter or prescription medications to thin the blood, prevent clots, and relieve pain. Severe cases of peripheral artery disease that negatively affect your ability to work or function may require surgery. Arterial bypass surgery or angioplasty and stent placement may be used, depending on the severity of the individual’s condition. Extreme cases of PAD may require amputation of the affected limb if no other treatment options are viable.
Arterial bypass surgery is an invasive procedure conducted under general anesthesia. During the procedure, the surgeon makes an incision in the affected artery and places clamps on each end of the blockage. The blocked portion of the artery is replaced with a graft that is stitched into place. The graft can be made from tissue taken from another blood vessel located elsewhere in the body or from artificial material. With the blockage removed and new arterial tissue in place, the clamps are removed and blood flow is restored.
An angioplasty and stent placement procedure is similar to one used for the heart. During the procedure, the individual may be given a local anesthetic and a mild sedative to help them relax. Using image-guided technology, such as live x-ray, a small incision can be made in the groin area and a catheter, known as a guidewire, inserted into the blocked artery. A second catheter, fitted with a balloon, is passed along the guidewire to the blockage where it is inflated to open the artery. While the balloon is in place, a stent is placed in the artery to keep it open, and the balloon is deflated and removed.
Lifestyle changes may also be recommended to help manage and relieve symptoms associated with PAD. Individuals who smoke may be advised to quit, as smoking contributes to arterial constriction and impaired circulation. Dietary changes, proactive cholesterol-lowering measures, and regular exercise may also be recommended to help manage symptoms.
Complications associated with peripheral artery disease can include the development of gangrene, amputation, blood clots, and heart disease. Risks associated with surgical procedures for PAD can include infections, difficulty breathing, and stroke. Additional complications associated with the surgery can include nerve or tissue damage, allergic reactions to the materials used or the medications administered, and excessive bleeding.
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