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Peripheral artery disease (PAD) is the accumulation of plaques (fat and cholesterol) within the legs or arms, making it harder for the blood to carry oxygen to tissue in the affected area. An individual with PAD develops a characteristic symptom of pain in the leg that starts with walking or exercise and goes away with rest.
Most plaques have a hard exterior while being soft on the inside, allowing platelets to attach to the plaque and forming blood clots. These clots gradually make the arteries even narrower. The reduced blood flow to the tissues can result in the formation of gangrene, especially in the toes and feet. PAD is a long-term disease; however, it can be reversed by exercising, consuming foods with less fat, and avoiding tobacco.
The Fontaine and Rutherford methods are used by medical professionals to grade the severity of PAD.
Stage I of Fontaine disease is asymptomatic
Stage II
Stage IIa involves mild claudication
Stage IIb denotes moderate to severe claudication
Stage III manifests as ischaemic rest discomfort
Stage IV indicates severe tissue damage and involves ulcers or gangrene
The Fontaine system streamlines classification, which helps with planning treatments and tracking the course of diseases.
Healthcare providers perform physical examinations, analyse medical histories, and evaluate risk factors to diagnose PAD and determine its severity. The identification of arterial blockages is aided by noninvasive techniques such as vascular ultrasonography, pulse volume recording (PVR), and ankle-brachial pressure index (ABI). The ABI test is commonly performed to measure the difference in systolic pressure between your arms and ankles. Based on the test results, further testing may be ordered to analyse the extent of blockage.
Comprehensive imaging of obstructions may need invasive angiograms. These diagnostic processes enable individualised management strategies for PAD and serve as a guide for therapy choices. Alternatively, Duplex ultrasonography and magnetic resonance angiography may also be used to find the exact location of the blockage.
Depending on the severity of PAD, various treatment options are available. Some of them are:
Medication to lower blood pressure, cholesterol, or for blood thinning
Angioplasty (procedure to open clogged blood vessels)
Atherectomy (a minimally invasive technique to remove plaque from blood vessels)
Stent placement
Untreated PAD raises the risk of amputation, particularly in diabetics, when the damaged leg may need to be removed entirely or partially. Because of the interconnectedness of the circulatory system, the effects of PAD might extend beyond the affected limb, as other body regions may be damaged by atherosclerosis.
Prompt diagnosis and treatment are essential to avoid complications such as strokes or heart attacks. To preserve vascular health and general well-being, regular monitoring and care of PAD are crucial for reducing the risk of systemic consequences and the need for amputation.
Healthy lifestyle choices—most notably, giving up smoking and continuing to exercise regularly—with a goal of 30 minutes per day are the first steps towards preventing PAD. Overall well-being is enhanced by following a balanced diet, such as the DASH diet, and practising mindfulness to reduce stress.
Reducing the risk of PAD requires careful management of diseases such as high blood pressure, diabetes, and high cholesterol. The chance of getting PAD is considerably reduced by taking proactive steps to address these risks, which also promotes vascular health.
PAD serves as a warning indicator because plaque development in the legs often implies its presence in other arteries. This can emerge as coronary artery disease in the heart, renal artery disease in the kidneys, or carotid artery disease in the arteries supplying the brain, increasing the risk of stroke.
Individuals with PAD and diabetes suffer a heightened risk of critical limb ischaemia, where non-healing ulcers or infections in the feet or legs may necessitate amputation in severe cases. Proactive care of PAD is critical to minimising systemic consequences and preserving vascular health.
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