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Peripheral artery disease - legs

Definition

Peripheral artery disease (PAD) is a condition of the blood vessels that supply the legs and feet. It leads to narrowing and hardening of the arteries. This causes decreased blood flow, which can injure nerves and other tissues.

Alternative Names

Peripheral vascular disease; PVD; PAD; Arteriosclerosis obliterans; Blockage of leg arteries; Claudication; Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of the legs; Recurrent leg pain and cramping; Calf pain with exercise

Causes

Peripheral artery disease is caused by arteriosclerosis, or "hardening of the arteries." This problem occurs when fatty material (plaque) builds up on the walls of your arteries and makes them narrower. The walls of the arteries also become stiffer and cannot widen (dilate) to allow greater blood flow when needed.

As a result, the muscles of your legs cannot get enough blood and oxygen when they are working harder (such as during exercise or walking). If PAD becomes severe, there may not be enough blood and oxygen, even when the muscles are resting.

Peripheral artery disease is a common disorder. It most often affects men over age 50, but women can have it as well. People are at higher risk if they have a history of:

Symptoms

The main symptoms of PAD are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms usually appear during walking or exercise, and go away after several minutes of rest.

When peripheral artery disease becomes severe, you may have:

Exams and Tests

During an exam, the health care provider may find:

When PAD is more severe, findings may include:

Blood tests may show high cholesterol or diabetes.

Tests for PAD include:

Treatment

Things you can do to control PAD include:

Medicines may be needed to control the disorder, including:

If you are taking medicines for high blood pressure or diabetes, take them as your doctor has prescribed.

Surgery may be performed if the condition is severe and is affecting your ability to work or do important activities, or you are having pain at rest. Options are:

Some people with PAD may need to have the limb removed (amputated).

Outlook (Prognosis)

Most cases of peripheral artery disease of the legs can be controlled without surgery. Although surgery provides good symptom relief in severe cases, angioplasty and stenting procedures are being used in place of surgery more and more often.

Possible Complications


When to Contact a Medical Professional

Call your health care provider if you have:

References

White CJ. Atherosclerotic Peripheral Arterial Disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 67.

Mills JL. Lower extremity arterial disease. In: Cronenwett JL, Johnston W, eds. Rutherford's Vascular Surgery. 7th ed. Philadelphia, PA: Saunders Elsevier; 2010:section 15.

Creager MA, Libby P. Peripheral arterial disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders; 2011:chap 61.

Wong PF, Chong LY, Mikhailidis DP, Robless P, Stansby G. Antiplatelet agents for intermittent claudication. Cochrane Database Syst Rev. 2011. Issue 11. Art No.: CD001272. DOI: 10.1002/14651858.CD001272.pub2.

Watson L, Ellis B, Leng GC. Exercise for intermittent claudication. Cochrane Database Syst Rev. 2008. Issue 4. Art No.: CD000990. DOI: 10.1002/14651858.CD000990.pub2.



Review Date: 5/27/2014
Reviewed By: Deepak Sudheendra, MD, Assistant Professor of Interventional Radiology & Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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