Atherosclerosis doesn’t just affect the heart. It can manifest in any blood vessel in the body, especially those of the lower extremities
Definition of Peripheral Arterial Disease
Peripheral arterial diseaseis the term used to describe atherosclerotic changes that can occur in the peripheral arteries. While peripheral arterial disease can refer to both the upper and lower extremities, very few patients are symptomatic from upper extremity disease.
The Anatomy of Peripheral Arterial Disease
The peripheral arteries are the arteries that feed the arms and legs, as opposed to the central arteries supplying the internal organs. The major blood vessels of the upper extremities are the brachial arteries. These divide in the lower arm to become the ulnar and radial arteries. In the lower extremities the external iliac arteries divide to become the deep and superficial femoral arteries (SFA). The superficial femoral artery travels down to the leg. Behind the knee it is called the popliteal artery. This vessel splits into three vessels in the lower leg: the posterior tibial artery, anterior tibial artery, and the peroneal artery.
Causes of Peripheral Arterial Disease
There are numerous causes that can lead to peripheral arterial disease. Smoking is a preventable cause. High cholesterol levels also contribute to worsening atherosclerotic disease. High cholesterol can cause the deposition of fatty plaques in the blood vessels that damage the peripheral arteries. These physiologic changes can lead to the symptoms that people experience with peripheral arterial disease.
Symptoms of Peripheral Arterial Disease
The symptoms will change depending on the location of the disease. Some people have peripheral arterial disease in the arms but most people develop symptoms in their legs. Symptoms include:
- Leg pain
- Pain that is worsened by walking
- Pain that is relieved with rest
- Hair loss
- Color changes of the skin
- Non healing wounds
- Coldness, numbness, or tingling
These symptoms develop because using the muscles increases the demand for oxygen. This demand cannot be met by the damaged arteries and the pain develops from oxygen deprivation.
Diagnosis of Peripheral Arterial Disease
The disease is first diagnosed using physical exam findings. Ultrasound findings combined with sequentially measuring the blood pressure in the legs can help determine the location and extent of peripheral arterial disease. Computed tomography (CT) can help show the exact areas of disease.
Prevention of Peripheral Arterial Disease
As is the case with any atherosclerosis, patients should maintain healthy cholesterol levels and eat a balanced diet. Patients should take their medications as prescribed and see a physician regularly.
Am I At Risk?
People asking themselves this question should have their cholesterol levels and blood pressure checked regularly by a physician. Furthermore, some people have genetic disorders that may predispose them to atherosclerosis. These patients may need more intensive medical therapy.
Treatment of Peripheral Arterial Disease
Medication and a structured walking regimen are the first line treatment for peripheral arterial disease. However, some patients will require open or endovascular intervention. Your vascular surgeon will tailor treatment to the individual needs of the patient. Angioplasty, stenting, and bypasses are all potential options to be discussed with your vascular surgeon.
To learn more about treatment procedures for this condition please visit the following:
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