If you’ve never heard of a condition called PAD, you aren’t alone. But it’s a condition that affects millions of people worldwide and can have serious consequences.
In fact, more than 200 million people worldwide have PAD, which is an acronym for peripheral artery disease. In the United States alone, more than 6.5 million adults ages 40 or older have PAD.
But what is the condition exactly, and how does it put your life, and limbs, at risk? Jonathan Braun, MD, vascular surgeon with West Tennessee Medical Group Jackson Surgical Associates, shares some insight.
Defining PAD
You know now that PAD stands for peripheral artery disease. This condition occurs when the peripheral arteries moving blood through the legs, stomach, arms and head are narrowed, inhibiting the flow of blood.
This is similar to the way coronary artery disease works. Whereas coronary artery disease involves a narrowing of the blood vessels around the heart, PAD involves the narrowing of the arteries in the extremities. It most commonly affects the legs.
While PAD can have more than one underlying cause, it is most often caused by atherosclerosis, an accumulation of plaque that causes the arteries to narrow and block up.
When a person develops PAD, it can lead to a variety of disconcerting symptoms, including:
- A decrease in the temperature of your lower leg or foot in comparison with the other leg or the rest of your body
- Erectile dysfunction, most commonly in men who have diabetes
- Foot or leg wounds that heal slowly or don’t heal at all
- Gangrene or dead tissue
- Leg pain that doesn’t disappear after rest
- Poor nail growth on the toes or hair growth on the legs
While leg pain can come from a variety of sources, including exercise, it’s important to have it checked out, particularly if accompanied by any other symptoms. Pay attention to the exact location of your leg pain—PAD-related leg pain affects the muscles rather than the joints.
How PAD Is Diagnosed & Treated
If you’re experiencing symptoms of PAD, your medical provider will likely conduct what’s known as an ankle brachial index. This test measures the blood pressure in your ankles, comparing it to the blood pressure in your arms, typically both before and after exercise.
In a “normal” ankle, the blood pressure should be at least 90 percent of the arm’s blood pressure, but narrowing caused by PAD can cause it to be much lower. Other tests may also be ordered to confirm a diagnosis, including Doppler and ultrasound imaging, CT angiography, MR angiography and standard angiography, which can all provide detailed images and measurements of the arteries in your lower body.
If your symptoms are the result of PAD, your treatment will vary depending on the severity of the blockages. In most cases, the focus of treatment is to reduce symptoms and prevent PAD from progressing. Taking prompt action can be the difference in saving your legs and your life.
Lifestyle changes are often the first line of defense. Regular physical activity, particularly under the supervision of a rehabilitation specialist, can help promote better circulation in the legs.
Your medical provider will probably also recommend you change your diet. PAD is often associated with high cholesterol levels, so minimizing saturated and trans fat in the diet can help you naturally lower cholesterol.
If you smoke, it’s vitally important that you stop. Tobacco smoke is a significant risk factor for PAD, and it also increases your risk of heart attack and stroke.
Beyond these lifestyle measures, your medical provider may also prescribe medications to lower cholesterol, manage high blood pressure, keep diabetes in check and prevent blood clots.
When PAD Is Severe: Saving the Limbs
In severe cases, or in instances where these measures don’t work, endovascular procedures or surgery may be needed. The goal of surgery is to clear the blockage in the peripheral arteries, which is typically done by using a vein from another part of the body to “bypass” the blocked-off artery.
Because amputation becomes necessary in rare circumstances due to PAD, it’s important to seek a prompt diagnosis and treatment plan if you experience symptoms related to the legs and other lower extremities. Early detection and effective treatment can be the difference—helping to salvage the limb.
If you have PAD, you’ll want to work with medical providers who are experts in this field. It’s important for a physician to have experience in diagnosing PAD and determining its severity, as well as a team proficient in providing advanced treatment as needed.
When the condition is managed carefully, only 5 to 10 percent of patients with a severe form of PAD will require amputation. The right care team can make all the difference.
West Tennessee Medical Group Jackson Surgical Associates has been providing expert, compassionate surgical care to those in west Tennessee for more than 50 years. Call (731) 664-7395 to learn more or to schedule an appointment for a surgical consultation.
