The extremities require an adequate blood supply for skin and tissue health and muscle performance. Occlusive peripheral arterial disease is a condition in which an artery that supplies fresh blood to an extremity, usually a leg, becomes partially or completely blocked. It may affect one or both legs and may be mild in one leg but severe in the other. Rarely, the condition develops in the arms, rather than the legs.
Cause
Occlusive peripheral arterial disease is often caused by arteriosclerosis, a condition in which the artery becomes stiffened. This reduces its ability to expand and accommodate an increased flow of blood when needed. Atherosclerosis, a type of arteriosclerosis, is the result of plaque forming on the artery wall. This causes or complicates peripheral arterial disease. Sometimes, peripheral arterial disease occurs after injury to a leg, inflammation of the artery or exposure to radiation, says MayoClinic.com.
Risk Factors
Risk factors for occlusive peripheral artery disease include smoking, obesity and a diagnosis of Type 1 or Type 2 diabetes. The risk increases as one ages and is higher in someone with a family history of the disease or a related cardiovascular condition. High blood pressure and high cholesterol also increase risk, as does evidence of atherosclerosis in other areas of the body. People who lead a sedentary lifestyle are more likely to develop occlusive peripheral arterial disease. According to MedlinePlus, a website maintained by the U.S. National Institutes of Health, people who undergo hemodialysis for kidney disease are at increased risk of developing the condition.
Symptoms
Peripheral arterial disease is typically characterized by difficulty in walking a long distance. Pain, cramping and burning develop, often forcing the person to rest before resuming his walk. He may limp in response to the pain. As the condition worsens, aches and muscle cramps may disturb rest periods and sleep. Numbness and a burning sensation in the toes may be present. The person may have a loss of hair below the knee, thickened toenails and dry or shiny skin. In the middle stages of the condition, the skin may appear pale, splotchy or dusky, becoming gray or blue as symptoms progress. In severe cases, the muscles may appear smaller as they begin to waste away. Sores may develop in the lower legs or feet; these may be difficult to treat.
Treatment
Treatment is often aimed at halting or slowing the progression of disease. Cilostazol is sometimes prescribed to improve blood flow to the affected area. Aspirin and clopidogrel bisulfate may be used to prevent blood clots in the narrowed artery. Pain medications may be recommended. Rarely, surgery is performed to amputate the leg, remove a blood clot or a plaque formation, or create a way for blood to bypass a blocked artery. Occasionally, a stent is put into place to help keep an artery open. Depending on the person's condition, a physician may recommend an exercise program as a means to develop small blood vessels that bypass the occluded artery.
Prevention
Most preventative measures for occlusive peripheral arterial disease involve healthy lifestyle habits. Avoidance of smoking, engaging in regular exercise and maintaining a healthy weight help prevent the condition, the Merck Manuals Home Edition says. Proper management of high blood pressure, high cholesterol and diabetes are also important. MayoClinic.com recommends eating a diet low in saturated fat to help avoid the condition.
References
- "Medical-Surgical Nursing;" Donna Ignatavicius, M.S., R.N. and Linda Workman, Ph.D., R.N.; 2002
- MedlinePlus: Peripheral Artery Disease - Legs
- The Merck Manuals Home Edition: Occlusive Peripheral Arterial Disease
- MayoClinic.com: Peripheral Artery Disease
