Arteries carry oxygen-rich blood from the heart to all areas of the body. They normally have a smooth lining that prevents blood clotting and promotes optimal blood flow. The arteries gradually narrow to the point where the flow of blood to the heart, brain and extremities becomes insufficient. In some cases, blood flow is completely blocked. The legs and feet are often the first areas to be affected, although some patients may have a stroke or mini-strokes from blockages in the carotid artery in the neck.
Vascular disease is a slow process that can gradually progress over a lifetime.
Risk factors include age, smoking, high blood pressure, high cholesterol, diabetes, and a history of heart disease. For many, there are no symptoms until the artery has narrowed by 60 percent or more. Some patients begin to experience excessive tiredness in their legs or leg cramping when they walk. In later stages of the disease, leg circulation may be so poor that pain occurs in the toes and feet during periods of rest and especially at night. In the most advanced stages, the legs and feet have such severe blockage that the normal growth and repair process is impaired in the extremity.