What is Peripheral Artery Disease (PAD)?

PAD is a circulatory disease in which blocked or stenotic arteries (narrowed) reduce blood flow to the extremities, most commonly, the legs and feet.

Arteries that supply blood to the legs can become narrowed over time due to fatty plaque buildup that blocks or restricts blood flow, making it painful to walk.

Peripheral artery disease (PAD), is a chronic, life-threatening circulatory condition.

What causes peripheral vascular disease?

The most common cause of PVD is atherosclerosis, the buildup of plaque inside the artery wall. Plaque reduces the amount of blood flow to the limbs. It also decreases the oxygen and nutrients available to the tissue. Blood clots may form on the artery walls, further decreasing the inner size of the blood vessel and block off major arteries.
Other causes of PVD may include:

• • Injury to the arms or legs
  • Irregular anatomy of muscles or ligaments
  • Infection

People with coronary artery disease (CAD) often also have PVD.

Who is at risk for peripheral vascular disease?

A risk factor increases your chance of developing a disease. Some can be changed, others cannot.

Risk factors that you can’t change:

• Age (especially older than age 50)

• History of heart disease

• Male gender

• Postmenopausal women

• Family history of high cholesterol, high blood pressure, or peripheral vascular disease

Risk factors that may be changed or treated include:

• Coronary artery disease
• Diabetes
• High cholesterol
• High blood pressure
• Overweight
• Physical inactivity
• Smoking or use of tobacco products

Those who smoke or have diabetes have the highest risk of complications from PVD because these risk factors also cause impaired blood flow.

What are the symptoms of peripheral vascular disease?

About half the people diagnosed with PVD are symptom free. For those with symptoms, the most common first symptom is painful leg cramping that occurs with exercise and is relieved by rest (intermittent claudication). During rest, the muscles need less blood flow, so the pain disappears. It may occur in one or both legs depending on the location of the clogged or narrowed artery.

Other symptoms of PVD may include:

• Changes in the skin, including decreased skin temperature, or thin, brittle, shiny skin on the legs and feet

• Weak pulses in the legs and the feet

• Gangrene (dead tissue due to lack of blood flow)

• Hair loss on the legs

• Impotence

• Wounds that won’t heal over pressure points, such as heels or ankles

• Numbness, weakness, or heaviness in muscles

• Pain (described as burning or aching) at rest, commonly in the toes and at night while lying flat

• Paleness when the legs are elevated

• Reddish-blue discoloration of the extremities

• Restricted mobility

• Severe pain when the artery is very narrow or blocked

• Thickened, opaque toenails

The symptoms of PVD may look like other conditions. See your healthcare provider for a diagnosis.

How is peripheral vascular disease diagnosed?

Along with a complete medical history and physical exam, IRCC Pakistan is offering following non-invasive vascular investigations:

• Ankle-brachial index (ABI)

• Doppler ultrasound flow studies

• Treadmill exercise test.

• Photoplethysmography (PPG)

• Pulse volume recording (PVR) waveform analysis

• Segmental pressure

• Reactive hyperemia test

• Toe perfusion Index

• Transcutaneous oxygen levels

• Transcutaneous carbon dioxide levels

What is the treatment for peripheral vascular disease?