Peripheral Artery Disease

Peripheral artery poor circulation

Last Updated December 20th, 2021

Overview of peripheral artery disease

Diseases of the circulatory system are very common in aged people. In the recent years, these diseases have been observed in young adults and children as well. These disorders mainly affect the arteries that supply to the brain, heart and the peripheries. Peripheral artery disease (PAD) is a disease belonging to the aforementioned category. It affects the arteries supplying to the parts of the body other than the heart and the brain. In the year 2010, nearly 202 million people were diagnosed with the disease all over the world. The present global burden is still quite high.

What is peripheral artery disease?

Peripheral artery diseasePeripheral artery disease is a disease of the arteries that supply blood to the different parts of the body except for the heart and the brain. It is characterized by an abnormal constriction of these arteries. An analogous condition is known as coronary artery disease when the cardiac arteries are narrowed and for the brain, it is known as cerebrovascular disease. The arteries of the legs are mainly affected in this case. However, the arteries in the other parts of the body may also be affected. The patients usually experience pain while walking or climbing stairs. The disease may aggravate and lead to complications like coronary artery disease and stroke in the advanced stages.

 

What causes peripheral artery disease?

A number of precipitating factors can predispose a person to peripheral artery diseases. These are discussed below-

  • Smoking: Active tobacco smokers have a 10 times higher risk of developing PAD than the non-smokers. Passive smokers can also suffer from damages to the endothelial lining and can also develop atherosclerosis at some point in time. Over 80-90% of the patients with PAD have a history of smoking.
  • Diabetes mellitus: It leads to severe damage to the smooth muscle and endothelial cells in the peripheral arteries. This increases the risks of peripheral artery diseases in the lower extremities.
  • Dyslipidemia: Elevation in the levels of LDL cholesterol and triglycerides in the blood can cause PAD.
  • Hypertension: High blood pressure can increase the risks of PAD and cerebrovascular diseases, especially in men.
  • Aging: Aged people have greater risks of PAD, heart attack, and stroke.

Peripheral artery poor circulationSome other associated risk factors of Peripheral Artery Diseases are as follows-

  • Overexertion and ischemic rest pain
  • Being 65 years or above
  • People in the age group of 50-69 who already have cardiovascular problems
  • People less than 50 years of age, with metabolic diseases
  • Abnormal lower extremity pulse rate
  • Patients with carotid, coronary or renal artery diseases
  • People having a Framingham risk score of 10-20%
  • People who frequently experience chest pain

 

What are the different types of Peripheral Artery Disease?

PAD has two distinct classifications. The first one is done according to the stage of the disease. This is given below-

Stage I: Mild obstruction of the peripheral blood vessels occurs in this case. Hence no symptoms are observed.

Stage II: Mild to moderate limping pain in the limb. It has two subtypes-

  • Stage II A: Limping while covering a larger distance.
  • Stage II B: Limping while covering a smaller distance.

Stage III: It is characterized by ischemic rest pain felt only in the feet.

Stage IV: Gangrene or necrosis of the limb.

  • Rutherford introduced a classification that includes four grades and seven categories. These are given below-

Grade 0: It is asymptomatic and does not have sub-categories.

Grade 1: It has three categories-

  • Category I: Mild limping (claudication)
  • Category II: Moderate claudication
  • Category III: Severe claudication

Grade 2 Category IV: Pain during rest occurs.

Grade 3 Category V: Mild tissue loss and ischemic ulceration occur.

Grade 4 Category VI: Major tissue loss occurs, accompanied by gangrene and ischemic ulcers.

What is/are the complication(s) of peripheral artery disease?

Peripheral artery renal stentOne very serious complication of peripheral artery disease is “varicose veins”. Varicose veins or Telangiectasia (spider veins) are types of vascular disorders in which the normal veins of the body become protruded, twisted, with a reddish or bluish discoloration and are found in the superficial portions of the body (immediately below the skin surface). These conditions are quite common after a certain age (60 in most cases). These veins are normally situated on the inner portions of the calves and the thigh and have a diameter greater than 3 mm.

They are formed primarily due to malfunctioning of the valves (valve reflux) and weakness (loss of elasticity) of the vein walls. These conditions cause these types of veins to allow backflow of blood that produces irregular bulges in different regions of the body (due to the accumulation of venous blood). Varicose veins mainly affect the superficial veins of the body and are manifested as twisted, lumped windings bulging out of the skin surface. Although varicose veins and spider veins are considered synonymous, spider veins have a smaller diameter (less than 1 mm). 

 

What are the available diagnostic tests?

Preliminary diagnosis of Peripheral Artery Disease is carried out via Duplex Ultrasound Examination which detects valve dysfunctions and presence of a venous blockage. Photoplethysmography (PPG) and Venography are also recommended in certain cases.

 

How can PAD be treated?

Cilostazol and Pentoxifylline are effective in improving the symptoms in some people. In addition to these, certain lifestyle changes like smoking cessation, management of diabetes, hypertension, and cholesterol are necessary to prevent the occurrence of the disease.

The following revascularization techniques can help recover from the condition-

  • Angioplasty: Can be done on the solitary lesions in large arteries.
  • Atherectomy: The plaque is scraped off the vessel wall.
  • Vascular bypass grafting: Circumvents the diseased area.
  • Thrombectomy: Applied for arterial thrombosis.

 

Prevention

Smoking is recognized as one of the major risk factors for the onset of peripheral artery disease. It is, thus, advised to refrain from active and secondhand smoke or tobacco consumption. It is also important to keep the blood sugar level and cholesterol level in check in order to both prevent and manage this condition. Medications must be aimed at reducing clot formation. A diet rich in essential nutrients, healthy fats, and fruits and vegetable is can help to prevent the onset of such conditions. Similarly, a basic level of physical activity ( 30 mins every day, 4 days a week) can also help counter the adverse effects.

Peripheral artery diseases are one of the leading causes of hospitalization and death at present. Cardiologists are warning people having a family history of similar diseases against possibilities of peripheral disorders in future. Regular check-ups are necessary after a certain age in order to detect vascular diseases at an early stage and reduce the mortality rates.

 

 

 

 

 

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How can Kegels help you overcome weak pelvic muscles & incontinence? Kegel exercises are pelvic floor strengthening exercises that can help you overcome incontinence issues that rise out of…
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The best and safest ways to treat rosacea Rosacea is a skin disease that is characterized by reddish hives and rashes on the face. Read more…
about mediterranean diet
Why you should be adopting a Mediterranean style of diet today Ever wondered why the Mediterranean diet is so healthy? One simple solution to lowering risk of several deadliest…
CERULOPLASMIN- triple marker
Triple Marker Test A triple marker test is an important prenatal test that is performed to detect the presence of chromosomal…
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Practical Motherhood Tips for Working Women Check out these effective tips for working mothers to manage motherhood and work life. Raise your children easily…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
BRAT Diet: What is the right way to follow this diarrhea-relieving diet? BRAT diet, a simple diet consisting of just bananas, rice, applesauce, and toast, can help you combat the…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…

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