Peripheral Artery Disease

Peripheral artery disease, or peripheral arterial disease, is a very common condition in which the narrowing or blockage of peripheral arteries limits blood flow to the limbs, usually as a result of atherosclerosis. As a consequence, the tissues in the arms and, more frequently, the legs do not receive sufficient oxygen and nutrients, and their function is affected.

Symptoms

Typically, peripheral arterial disease does not present symptoms. When they do appear, they vary depending on the affected area:

• Intermittent claudication: pain, cramps, discomfort, or aching in the legs when walking, relieved by rest. It usually manifests in the calves but can also occur in the feet, thighs, hips, buttocks, or, rarely, in the arms. It is the typical symptom of this condition and can be very limiting.
• Pain in the arms when performing manual tasks.
• Cold sensation in one leg, especially when compared to the other limb.
• Weak pulse in the legs.
• Weakness or numbness.
• Paleness or bluish coloration.
• Appearance of ulcers or wounds that heal very slowly on the feet or legs.
• Slower growth of toenails and leg hair.
• Embolism in the hands.
• In severe cases, leg pain at rest.

Causes

The primary cause of peripheral artery disease is atherosclerosis, which causes a progressive buildup of atherosclerotic plaques (cholesterol and other fatty deposits) in the arterial walls, leading to the progressive narrowing of peripheral arteries.

Less frequently, it may be caused by:

• Abnormal growth of the arterial wall.
• Vascular inflammation.
• Presence of a cyst or fluid sac pressing the artery from the outside.
• Formation of a clot in an already narrowed artery.

Risk Factors

Factors that increase the likelihood of developing peripheral artery disease include:

• Age: it is more common after age 65.
• Family history of atherosclerosis, heart disease, vascular diseases, or strokes.
• Smoking, as it damages blood vessels, increases blood pressure, and reduces blood flow.
• Diet rich in saturated fats.
• Lack of physical activity.
• Diabetes.
• Elevated homocysteine levels, an amino acid that increases the risk of coronary artery conditions.
• High cholesterol.
• Hypertension, which can harden the arteries.
• Obesity: it can cause diabetes and hypertension.

Complications

The most common complications of peripheral arterial disease include:

• Ischemia (ischemic artery disease): blood flow is completely blocked, and tissues die, causing gangrene and promoting the appearance of ulcers and sores that do not heal. If the situation does not improve, amputation of the limb may be required.
• Strokes.
• Heart attacks.

Prevention

To prevent peripheral artery disease, a healthy lifestyle must be adopted:

• Quit smoking.
• Follow a heart-healthy diet: low in sodium, sugar, and saturated fats, and rich in proteins and vegetables.
• Exercise regularly.
• Maintain a healthy weight.
• Control blood pressure, cholesterol, and blood glucose levels.

Which Doctor Treats Peripheral Artery Disease?

Peripheral artery disease is diagnosed and treated by specialists in angiología (angiology) and vascular surgery, as well as by members of the cardiovascular risk unit and the interventional vascular radiology unit.