What is Peripheral Artery Disease?
Peripheral arteries supply blood to the outer areas of the body; Peripheral Artery Disease (PAD) is a narrowing or blockage of those arteries—most commonly in the pelvis and legs—which reduces the flow of oxygen-rich blood to your limbs. Approximately 10 million American suffer from PAD, which is most commonly caused by atherosclerosis, a build-up of fat and cholesterol deposits called 'plaques' that hardens over time.
PAD can be a hereditary condition, with risk factors that include obesity, diabetes, smoking, high blood pressure, aging, and physical inactivity. A potentially serious condition, PAD is more successfully treated if it's caught early.
Peripheral Artery Disease Symptoms and Diagnosis
While PAD may develop without any obvious signs, patients suffering from the disease may experience the following symptoms:
- Claudication, which is pain, fatigue, tightness, or cramping in the leg(s) after exercise
- Coldness or numbness in the arms, legs, fingers, or toes
- Thinning or loss of hair on the arms and legs
- Skin ulcers
- Muscle spasms
- Loss of sensation in the arms or legs
- Erectile dysfunction
Diagnosis of PAD could include a physical exam in which your doctor checks the strength of the pulse in your legs and uses a stethoscope to listen to the circulation in your legs. Tests can include an ankle-brachial index (which compares blood pressure in the leg to normal arm blood pressure), blood tests, a treadmill test, ultrasound, MRI, electrocardiogram, or an angiography (an X-Ray of blood vessels that have been injected with dye).
Medications for Managing Peripheral Artery Disease (PAD)
The goal of managing PAD is to reduce symptoms, improve function and prevent future cardiovascular issues (i.e. stroke, myocardial infarction, etc.). When choosing a treatment plan for PAD, Mount Sinai physicians consider factors including a patient's age, lifestyle and status of PAD.
While lifestyle changes to address PAD's risk factors are effective (such as losing weight, increasing exercise, and quitting smoking), your doctor may give you a prescription to help manage the disease. Possible medications to treat PAD include antiplatelet agents (such as aspirin), cholesterol-lowering agents (such as statins), medications to reduce leg pain, and medications to enlarge the diseased arteries.
Procedures to Treat Peripheral Artery Disease (PAD)
Mount Sinai offers expertise in the full range of non-surgical and surgical procedures to treat PAD. Our physicians are highly-skilled in performing the following:
- Balloon angioplasty, which places a removable balloon at the problem site, where it is inflated to stretch the artery
- Stent implant, which places a wire mesh tube at the problem site, where it is expanded to keep the artery open
- Atherectomy, which using a small instrument with a revolving blade to break up the blockage
- Endarterectomy, a surgery to remove the plaque material (blockage) in the lining of the artery
- Bypass surgery, which replaces the diseased vessel with a vein from another part of the body or a synthetic graft