Peripheral Arterial Disease

Blood Vessels

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Arteries are the blood vessels that carry blood from your heart to your organs and tissues. Peripheral arteries are the arteries in your arms and legs. Peripheral arterial disease is when an artery, usually in your leg, becomes partly or completely blocked. This blockage can occur slowly over many years, or all of a sudden. If blood can't reach parts of your body, the tissue dies from lack of oxygen.

• Peripheral arterial disease is usually caused by hardening of the arteries (atherosclerosis)

• It's more likely in smokers and in people with high blood pressure, diabetes, and high cholesterol

• Symptoms include pain or cramps in one leg that come when you walk and go away when you rest

• With severe peripheral arterial disease, your leg may hurt all the time and you may get skin sores

• If your leg artery is suddenly blocked completely, you'll get gangrene (death of tissues caused by a lack of blood) and need an amputation unless the blockage is opened up right away

• Doctors give you medicines or do surgery to fix the blockage and ease symptoms

Go to the hospital right away if your arm or leg suddenly becomes painful, cool, and pale. Your artery could be blocked.

Arteries of the Leg

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Peripheral arterial disease can happen when an artery:

• Gradually gets narrower when fats or cholesterol build up on the walls of the artery (atherosclerosis)

• Is suddenly blocked by a blood clot

The biggest risk factor is:

• Atherosclerosis

Because it takes a long time for the arteries to get narrow, most people don't have peripheral arterial disease before age 55.

Other important risk factors include:

• Smoking cigarettes

• Diabetes

• High cholesterol

• Family members with atherosclerosis

Men and people who are obese have a slightly increased risk.

Peripheral arterial disease is rare in the arms. Most often you'll get symptoms only in your legs.

If your artery is getting narrower over time, you'll have:

• Painful, aching, cramping, or a tired feeling in your leg that happens when you walk and goes away with a short rest (intermittent claudication)

Later on, with more severe narrowing, you may:

• Be unable to walk as far as you used to

• Have pain even when resting

• Have sores on your toes or heel

• Have skin wounds that take a long time to heal

If your symptoms suddenly get worse, see a doctor right away.

If your artery is suddenly and completely blocked, your arm or leg will be:

• Very painful

• Cold

• Numb

• Pale

Go to the hospital right away. A large blockage can cause gangrene (death of tissues caused by a lack of blood). If blood is blocked from getting to your arm or leg for too long, your arm or leg may need to be amputated (surgically cut off).

Doctors will ask about your symptoms and do a physical exam. Doctors may also do tests, such as:

• Checking your pulse at different places in your body (there will be no pulse below where the artery is completely blocked)

• Oxygen tests using sensors on your skin to see if oxygen is getting to different parts of your body

• Ultrasound to measure blood flow in the arm or leg

• Angiography—sometimes CT (computed tomography) angiography or magnetic resonance angiography (MRA)—if doctors are considering surgery

To treat peripheral arterial disease, doctors use:

• Medicines that help increase blood flow

• Surgery to take out blood clots or bypass your blocked artery

• Angioplasty (a procedure to open the blockage using a tiny balloon and keep it widened using a small wire tube, called a stent)

If the arm or leg has died or there's no way to get blood to it, it may need to be amputated (surgically removed).

Doctors may tell you to:

• Stop smoking cigarettes

• Walk at least 30 minutes a day, 3 days per week

• Work with a physical or occupational therapist in a rehabilitation program

• Avoid cold, which makes your blood vessels narrower

• Avoid certain medicines that make your blood vessels narrower, such as some cold and sinus medicines

• Take good care of your feet to prevent wounds and infections

To prevent peripheral arterial disease:

• Don’t smoke cigarettes

• Control your blood sugar levels (if you have diabetes)

• Lower blood pressure and cholesterol levels

• Lose weight

• Be active and get exercise