A common type of peripheral vascular disease is peripheral artery disease (PAD), which is also known as claudication, leg artery disease or occlusive artery disease. PAD, a common circulatory system disease, occurs when arteries in the lower extremities are blocked, clogged or narrowed. According to S. Bhimji, M.D., approximately 10 million people in the United States have been diagnosed with PAD. Narrowed or blocked arteries reduce the amount of blood supply to the lower extremities, and as a result, the legs do not receive sufficient blood. Typically, leg pain or cramping will occur when walking, with pain that potentially radiates up as far as the hips. This disease requires medical treatment.
Etiology
The largest artery in the body, the aorta, carries blood from the heart to the rest of the body. The aorta splits into two other arteries called iliac arteries, which then send blood into the lower extremities. The iliac arteries then divide into what is known as the femoral arteries. Other, smaller arteries branch off from the femoral arteries and take blood further down to the feet.With age, arteries become clogged with plaque, which consists of cholesterol, calcium and fibrous tissue; this process is atherosclerosis, commonly referred to as hardening of the arteries.
Atherosclerosis and plaque concentration typically occur equally through the body; therefore PAD usually is an indicator of additional systemic arterial disease. Consequently, a person with PAD is at increased risk for a heart attack, aortic aneurysms and stroke.
Symptoms
When symptoms appear, the most common one is intermittent claudication (IC). IC produces pain in the legs when walking, which at first may ease with rest. The specific region that's painful usually indicates the location of arterial occlusion; however, calf pain is reported most frequently. Other symptoms reported include tightness or cramping and heavy or weak sensations in the extremity during activity. Other possible symptoms are numbness or weakness in the affected leg, colder temperature of the affected leg in comparison to the other leg, color change in the affected leg, and hair loss of the involved leg and possibly foot.
Severe PAD may produce a symptom known as critical limb ischemia that occurs when the leg suffers from insufficient oxygen. This symptom can occur at rest and produce pain that radiates to the feet and toes. Another symptom of advanced disease is painful ulcers or sores that appear on toes or feet and usually begin as dry gray or black sores. Without medical intervention, these sores will lead to dead tissue as well as amputation in response to gangrene.
Factors
According to the Vascular Disease Foundation, the number one risk factor for PAD is smoking. Other risk factors are family history of heart attacks, aneurysms or strokes; age, specifically being over the age of 50; obesity, sedentary lifestyle and diabetes; and hypertension as well as high cholesterol.
References
- Peripheral Vascular Disease Overview; S. Bhimji, M.D., K. Hale; 2005
- Vascular Disease Foundation
- Society of Interventional Radiology
