background

What Does The Term 'Peripheral Artery Disease' Mean?

Peripheral Artery Disease affects those arteries that are present in the legs, arms, neck, and kidneys. The arteries that are affected include the femoral artery(thigh), radial artery(forearm), brachial artery(upper arm), and so on. Peripheral artery disease mostly impacts the legs, resulting in the occurrence of common symptoms called intermittent claudication, where sharp pain is experienced in the calf muscle. Other symptoms include reduced pulse in the feet, numbness of toes, ulcers on the affected limb that do not heal easily, etc.

Development Of Peripheral Artery Disease

Peripheral arteries are a part of the circulatory system that are present in the legs, arms, feet, kidneys, and so on. The peripheral arteries supply oxygen-rich blood to the body and take deoxygenated blood to the heart for its oxygenation. Peripheral artery disease takes place when fatty deposits like triglycerides, 'bad cholesterol' (low-density lipoprotein) get accumulated in the walls of the peripheral arteries. This causes a slight injury in the walls and to heal, platelets travel to that area which forms blood clots around the area(thrombosis).

Gradually others substances that flow along with the bloodstream like calcium, sodium, and other substances stick to the walls. All these substances combine with the fatty deposits to form 'plaque'. This substance hardens and if cracks, platelets reach the area, forming more blood clots, resulting in narrowing of the blood vessels. When the arteries are narrowed and completely damaged, the tissues present in the legs, feet, arms, are damaged too, leading to peripheral artery disease.

Signs And Symptoms

The signs and symptoms include :-

  • Intermittent Claudication - this is the first noticeable symptom of peripheral artery disease. This term is referred to a sharp pain felt in the calf muscle during vigorous exercise. This pain usually dies away when the individual is at rest.
  • Aching pain in feet and toes while resting
  • Redness or other exterior changes in the skin
  • Painful cramping in thighs and hips while engaging in normal activities like walking
  • Weakness in the legs; numbness
  • Coldness felt in the legs or foot
  • Sores on toes, feet, legs which do not heal
  • Slower hair growth on the legs
  • Slowed growth of toes or toenails
  • Skin appears to be shiny on the legs
  • Weak pulse of feet, legs
  • Erectile dysfunction in men
Risk Factors
The risk factors associated with peripheral artery disease are:-
  • Genetics - genes control every part of the circulatory system. If the parent went through narrowing of the arteries during their pregnancy, the child is mostly like to develop peripheral artery disease since the child shares the DNA of its mother.
  • Increasing age - since during the period of late adulthood, the body's genetic programming reduces, increasing the chance of narrowing of arteries.
  • Smoking - actively smoking or increased exposure to smoke increases the risk of having peripheral artery disease because smoking makes the blood sticky, and it is most likely to clot, which can obstruct the blood flow to the heart. It also lowers good cholesterol in the body.
  • High blood pressure - High blood pressure or hypertension makes the peripheral arteries less elastic, which reduces blood flow to the body. This makes the peripheral arteries work harder, causing stiffening of the muscle and death of the cells present in it.
  • Cholesterol - The total number of cholesterol in the blood also affects the peripheral artery wall. There are two types of cholesterol, High-density lipoprotein, and low-density lipoprotein. The high-density lipoprotein is good for the heart since it helps in removing cholesterol deposits from the peripheral arteries and transports them to the liver, which then removes them from the body. The low-density lipoprotein transports cholesterol from the liver to other tissues and cells, which use this as energy. Low-density lipoprotein, along with triglycerides, gets deposited in the arterial wall, obstructing the blood flow.
  • Obesity - Obese individuals require more blood so that they can carry oxygen and nutrients to the tissues to function efficiently. This puts pressure on the peripheral arteries to work harder to supply blood.
  • Diabetes - When your body does not respond to insulin or does not produce much insulin, glucose remains in the bloodstream. This causes an increase in the blood sugar level. An increase in blood sugar damages the walls of arteries due to fatty deposits in the walls.
  • Arteriosclerosis - loss of elasticity of the walls of the arteries.
  • Gangrene - is a condition where the color of the skin in toes or feet changes to black. This happens due to tissue death by a lack of blood supply in the affected area
Further Complications
Peripheral artery disease, if not cured, can result in:-
  • Heart Attack - Heart attack or myocardial infarction happens when blood supply to the heart suddenly stops. Myocardial infarction means the death of a heart muscle, which means a heart attack takes place when blood is not reaching the heart muscle, which causes the heart muscle to stop functioning or die. This mainly happens due to plague (cholesterol) deposits in the walls of the coronary artery, which block the passage of blood flow to the heart muscle. If the blood supply to a heart muscle is very low, it ruptures the entire pumping system of the heart, which includes blood vessels, arteries, capillaries, and veins. In some situations, the skin turns blue since the organs of the body are not getting enough blood.
  • Heart Failure - Congestive cardiac failure can take place when the heart has completely lost its ability to pump blood to other organs of the body. Heart failure results in developing excess fluid in and around the lungs, coughing blood, shortness of breath, swelling of the abdomen, legs, and ankles.
  • Cardiac Arrest - happens when there is a sudden loss of blood in the body due to failure of the heart to pump blood. It requires immediate action like performing CPR to restore the lack of oxygen in the body.
  • Critical limb ischemia - known as the advanced stage of peripheral artery disease, this includes the damage of limb tissue, resulting in gangrene, ulcers, etc.
Prevention And Treatment
This includes:-
  • Tests - Low-Density Lipoprotein and High-Density Lipoprotein test to check the amount of good cholesterol and bad cholesterol in the blood, C-Reactive Protein test to check whether the immune system is performing its function of fighting illness. If not, CRP will be lower. International Normalized Ratio (INR) checks the tendency of the blood to clot, blood pressure test, Triglyceride test to check the number of fatty acids in the body, calcium scan to check calcium deposits in the peripheral arteries that cause narrowing of arteries
  • Medications - SGLT2 inhibitors or gliflozins reduce blood glucose levels without activating the release of insulin from the pancreas. They also reduce blood pressure in diabetic patients. GLP-1 helps reduce obesity, hypertension, and blood sugar levels. PCSK9 inhibitors are also given to reduce cholesterol levels or low-density lipoprotein in the patient's circulatory system. High doses of omega-3 can help reduce triglycerides and cholesterol from the bloodstream. Niacin, a B-vitamin, helps raise good cholesterol in the body.
  • Physical examination includes blood pressure test, triglyceride test to check the number of fatty acids in the body, peripheral calcium scan to check calcium deposits in the peripheral arteries that cause narrowing of the arteries. The examiner might ask for any unusual changes that might have occurred in your body. This helps the examiner to analyze your medical history.
  • Primary Angioplasty - This procedure involves widening the peripheral artery walls where cholesterol deposits are present. The narrowed areas of the artery walls are widened by using a long, flexible tube (catheter) and placing it in between the plaque deposits. The catheter is inserted into the main blood vessel of the lower arm and passed carefully into the aorta. A balloon is placed at the tip of the tube in such a way that when it is blown, it forces the narrowed areas of the artery to wide open. This clears the passage of the artery walls.
  • Coronary Thrombectomy - This treatment involves removing a blood clot(thrombus) from the blood vessel. The formation of blood clots can take place when a person has peripheral artery disease. When the plague deposits in the body, it obstructs blood flow from the peripheral arteries and veins.
  • Alcohol septal ablation - This procedure involves injecting alcohol(ethanol) into the part where the muscle has thickened. It kills the cells of the muscle and shrinks the diseased tissue and restores blood flow in it.
  • Atherectomy - This treatment provides an alternative to angioplasty where it cuts the plague from the wall of the peripheral arteries, instead of pushing it into the wall

Dr. Swapnil Mate's Cardiology clinic specializes in treating coronary and peripheral artery diseases and identifying the signs and symptoms that contribute to serious medical conditions like stroke, chronic limb ischemia. Their cardiology team is trained to eradicate the risk factors that hamper the overall health of the patient. Consult Dr. Swapnil Mate for the best medical assistance.

  BOOK NOW|   CALL NOW|  CHAT