Question: What is (are) Peripheral Artery Disease ?
Answer: Peripheral artery disease (P.A.D.) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When plaque builds up in the body's arteries, the condition is called atherosclerosis. Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. P.A.D. usually affects the arteries in the legs, but it also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs. Normal Artery and Artery With Plaque Buildup Overview Blocked blood flow to your legs can cause pain and numbness. It also can raise your risk of getting an infection in the affected limbs. Your body may have a hard time fighting the infection. If severe enough, blocked blood flow can cause gangrene (tissue death). In very serious cases, this can lead to leg amputation. If you have leg pain when you walk or climb stairs, talk with your doctor. Sometimes older people think that leg pain is just a symptom of aging. However, the cause of the pain could be P.A.D. Tell your doctor if you're feeling pain in your legs and discuss whether you should be tested for P.A.D. Smoking is the main risk factor for P.A.D. If you smoke or have a history of smoking, your risk of P.A.D. increases. Other factors, such as age and having certain diseases or conditions, also increase your risk of P.A.D. Outlook P.A.D. increases your risk of coronary heart disease, heart attack, stroke, and transient ischemic attack("mini-stroke").Although P.A.D. is serious, it's treatable. If you have the disease, see your doctor regularly and treat the underlying atherosclerosis.P.A.D. treatment may slow or stop disease progress and reduce the risk of complications. Treatments include lifestyle changes, medicines, and surgery or procedures. Researchers continue to explore new therapies for P.A.D.
Source: NHLBI

Question: Who is at risk for Peripheral Artery Disease? ?
Answer: Peripheral artery disease (P.A.D.) affects millions of people in the United States. The disease is more common in blacks than any other racial or ethnic group.The major risk factors for P.A.D. are smoking, older age, and having certain diseases or conditions. Smoking Smoking is the main risk factor for P.A.D. and your risk increases if you smoke or have a history of smoking. Quitting smoking slows the progress of P.A.D. People who smoke and people who have diabetes are at highest risk for P.A.D. complications, such as gangrene (tissue death) in the leg from decreased blood flow. Older Age Older age also is a risk factor for P.A.D. Plaque builds up in your arteries as you age.Older age combined with other risk factors, such as smoking or diabetes, also puts you at higher risk for P.A.D. Diseases and Conditions Many diseases and conditions can raise your risk of P.A.D., including: Diabetes High blood pressure High blood cholesterol Coronary heart disease Stroke Metabolic syndrome
Source: NHLBI

Question: What are the symptoms of Peripheral Artery Disease ?
Answer: Many people who have peripheral artery disease (P.A.D.) dont have any signs or symptoms. Even if you don't have signs or symptoms, ask your doctor whether you should get checked for P.A.D. if you're: Aged 70 or older Aged 50 or older and have a history of smoking or diabetes Younger than 50 and have diabetes and one or more risk factors for atherosclerosis Intermittent Claudication People who have P.A.D. may have symptoms when walking or climbing stairs, which may include pain, numbness, aching, or heaviness in the leg muscles.Symptoms also may include cramping in the affected leg(s) and in the buttocks, thighs, calves, and feet. Symptoms may ease after resting.These symptoms are called intermittent claudication. During physical activity, your muscles need increased blood flow. If your blood vessels are narrowed or blocked, your muscles won't get enough blood, which will lead to symptoms. When resting, the muscles need less blood flow, so the symptoms will go away. Other Signs and Symptoms Other signs and symptoms of P.A.D. include: Weak or absent pulses in the legs or feet Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all A pale or bluish color to the skin A lower temperature in one leg compared to the other leg Poor nail growth on the toes and decreased hair growth on the legs Erectile dysfunction, especially among men who have diabetes
Source: NHLBI

Question: How to diagnose Peripheral Artery Disease ?
Answer: Peripheral artery disease (P.A.D.) is diagnosed based on your medical and family histories, a physical exam, and test results. P.A.D. often is diagnosed after symptoms are reported. A correct diagnosis is important because people who have P.A.D. are at higher risk for coronary heart disease (CHD), heart attack, stroke, and transient ischemic attack ("mini-stroke"). If you have P.A.D., your doctor also may want to check for signs of these diseases and conditions. Specialists Involved Primary care doctors, such as internists and family doctors, may treat people who have mild P.A.D. For more advanced P.A.D., a vascular specialist may be involved. This is a doctor who specializes in treating blood vessel diseases and conditions. A cardiologist also may be involved in treating people who have P.A.D. Cardiologists treat heart problems, such as CHD and heart attack, which often affect people who have P.A.D. Medical and Family Histories Your doctor may ask: Whether you have any risk factors for P.A.D. For example, he or she may ask whether you smoke or have diabetes. About your symptoms, including any symptoms that occur when walking, exercising, sitting, standing, or climbing. About your diet. About any medicines you take, including prescription and over-the-counter medicines. Whether anyone in your family has a history of heart or blood vessel diseases. Physical Exam During the physical exam, your doctor will look for signs of P.A.D. He or she may check the blood flow in your legs or feet to see whether you have weak or absent pulses. Your doctor also may check the pulses in your leg arteries for an abnormal whooshing sound called a bruit. He or she can hear this sound with a stethoscope. A bruit may be a warning sign of a narrowed or blocked artery. Your doctor may compare blood pressure between your limbs to see whether the pressure is lower in the affected limb. He or she also may check for poor wound healing or any changes in your hair, skin, or nails that may be signs of P.A.D. Diagnostic Tests Ankle-Brachial Index A simple test called an ankle-brachial index (ABI) often is used to diagnose P.A.D. The ABI compares blood pressure in your ankle to blood pressure in your arm. This test shows how well blood is flowing in your limbs. ABI can show whether P.A.D. is affecting your limbs, but it won't show which blood vessels are narrowed or blocked. A normal ABI result is 1.0 or greater (with a range of 0.90 to 1.30). The test takes about 10 to 15 minutes to measure both arms and both ankles. This test may be done yearly to see whether P.A.D. is getting worse. Ankle-Brachial Index Doppler Ultrasound A Doppler ultrasound looks at blood flow in the major arteries and veins in the limbs. During this test, a handheld device is placed on your body and passed back and forth over the affected area. A computer converts sound waves into a picture of blood flow in the arteries and veins. The results of this test can show whether a blood vessel is blocked. The results also can help show the severity of P.A.D. Treadmill Test A treadmill test can show the severity of symptoms and the level of exercise that brings them on. You'll walk on a treadmill for this test. This shows whether you have any problems during normal walking. You may have an ABI test before and after the treadmill test. This will help compare blood flow in your arms and legs before and after exercise. Magnetic Resonance Angiogram A magnetic resonance angiogram (MRA) uses magnetic and radio wave energy to take pictures of your blood vessels. This test is a type of magnetic resonance imaging (MRI). An MRA can show the location and severity of a blocked blood vessel. If you have a pacemaker, man-made joint, stent, surgical clips, mechanical heart valve, or other metallic devices in your body, you might not be able to have an MRA. Ask your doctor whether an MRA is an option for you. Arteriogram An arteriogram provides a "road map" of the arteries. Doctors use this test to find the exact location of a blocked artery. For this test, dye is injected through a needle or catheter (tube) into one of your arteries. This may make you feel mildly flushed. After the dye is injected, an x ray is taken. The xray can show the location, type, and extent of the blockage in the artery. Some doctors use a newer method of arteriogram that uses tiny ultrasound cameras. These cameras take pictures of the insides of the blood vessels. This method is called intravascular ultrasound. Blood Tests Your doctor may recommend blood tests to check for P.A.D. risk factors. For example, blood tests can help diagnose conditions such as diabetes and high blood cholesterol.
Source: NHLBI

Question: What are the treatments for Peripheral Artery Disease ?
Answer: Treatments for peripheral artery disease (P.A.D.) include lifestyle changes, medicines, and surgery or procedures. The overall goals of treating P.A.D. include reducing risk of heart attack and stroke; reducing symptoms of claudication; improving mobility and overall quality of life; and preventing complications. Treatment is based on your signs and symptoms, risk factors, and the results of physical exams and tests. Treatment may slow or stop the progression of the disease and reduce the risk of complications. Without treatment, P.A.D. may progress, resulting in serious tissue damage in the form of sores or gangrene (tissue death) due to inadequate blood flow. In extreme cases of P.A.D., also referred to as critical limb ischemia (CLI), removal (amputation) of part of the leg or foot may be necessary. Lifestyle Changes Treatment often includes making long-lasting lifestyle changes, such as: Physical activity Quitting smoking Heart-healthy eating Physical Activity Routine physical activity can improve P.A.D. symptoms and lower many risk factors for atherosclerosis, including LDL (bad) cholesterol, high blood pressure, and excess weight. Exercise can improve the distances you can comfortably walk. Talk with your doctor about taking part in a supervised exercise program. If a supervised program is not an option, ask your doctor to help you develop an exercise plan. Most exercise programs begin slowly, which includes simple walking alternating with rest. Over time, most people build up the amount of time they can walk before developing pain. The more active you are, the more you will benefit. Quitting Smoking If you smoke, quit. Smoking raises your risk for P.A.D. Smoking also raises your risk for other diseases, such as coronary heart disease and heart attack, and worsens other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhandsmoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Read more about quitting smoking at Smoking and Your Heart. Heart-Healthy Eating Your doctor may recommend heart-healthy eating to treat atherosclerosis, the most common cause of P.A.D. Following heart-healthy eating can help control blood pressure and cholesterol levels, which can lead to atherosclerosis. Medicines Your doctor may prescribe medicines to: Prevent blood clots from forming due to low blood flow with anticlotting medicines, such as aspirin. Treat unhealthy cholesterol levels with statins. Statins control or lower blood cholesterol. By lowering your blood cholesterol level, you can decrease your chance of developing complications from P.A.D. Treat high blood pressure with one of many high blood pressure medicines. Help ease leg pain that occurs when you walk or climb stairs. Reduce the symptoms of intermittent claudication, measured by increased walking distance with certain platelet-aggregation inhibitors. Surgery or Procedures Bypass Grafting Your doctor may recommend bypass grafting surgery if blood flow in your limb is blocked or nearly blocked. For this surgery, your doctor uses a blood vessel from another part of your body or a synthetic tube to make a graft. This graft bypasses (that is, goes around) the blocked part of the artery. The bypass allows blood to flow around the blockage. This surgery doesnt cure P.A.D., but it may increase blood flow to the affected limb. Angioplasty and Stent Placement Your doctor may recommend angioplasty to restore blood flow through a narrowed or blockedartery. During this procedure, a catheter (thin tube) with a balloon at the tip is inserted into a blocked artery. The balloon is then inflated, which pushes plaque outward against the artery wall. This widens the artery and restores blood flow. A stent (a small mesh tube) may be placed in the artery during angioplasty. A stent helps keep the artery open after angioplasty is done. Some stents are coated with medicine to help prevent blockages in the artery. Atherectomy Atherectomy is a procedure that removes plaque buildup from an artery. During the procedure, a catheter is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off plaque. The bits of plaque are removed from the body through the catheter or washed away in the bloodstream (if theyre small enough). Doctors also can perform atherectomy using a special laser that dissolves the blockage. Other Types of Treatment Researchers are studying cell and gene therapies to treat P.A.D. However, these treatments arent yet available outside of clinical trials. Read more about clinicaltrials.
Source: NHLBI

Question: How to prevent Peripheral Artery Disease ?
Answer: Taking action to control your risk factors can help prevent or delay peripheral artery disease (P.A.D.) and its complications. Know your family history of health problems related to P.A.D. If you or someone in your family has the disease, be sure to tell your doctor. Controlling risk factors includes the following. Be physically active. Be screened for P.A.D. A simple office test, called an ankle-brachial index or ABI, can help determine whether you have P.A.D. Follow heart-healthy eating. If you smoke, quit. Talk with your doctor about programs and products that can help you quitsmoking. If youre overweight or obese, work with your doctor to create a reasonable weight-loss plan. The lifestyle changes described above can reduce your risk of developing P.A.D. These changes also can help prevent and control conditions that can be associated with P.A.D., such as coronary heart disease, diabetes, high blood pressure, high blood cholesterol, andstroke.
Source: NHLBI