PERIPHERAL ARTERIAL DISEASE (PAD)

Dr Chandan Modak

Peripheral arterial disease is a disorder of the blood vessels outside the brain and heart. Heart attack is due to the blockage of the blood vessels supplying the heart. Similarly leg attack, intestinal attack can happen when the blood vessels to these organs are blocked. The basic mechanism is similar to that of coronary artery disease with most common cause is atherosclerosis which means there is deposition of bad cholesterol inside the blood vessel wall leading to narrowing of the lumen of the vessel.

Peripheral arterial disease is narrowing of the blood vessels to the legs and arms.When there is a reduced blood supply to the leg, this causes thigh and calf muscle pain while walking. Pain disappears during rest.

RISK FACTORS:

• DIABETES
• HIGH BLOOD PRESSURE
• HIGH CHOLESTEROL
• SMOKING
• OBESITY
• OLD AGE GROUP
• A FAMILY HISTORY OF PAD, CORONARY ARTERY DISEASE OR STROKE

• Cramping or fatigue in the legs while walking
• Non-healing ulcers on the feet or legs
• Pain in the feet while on bed
• Numbness and tingling
• Coldness in lower leg or foot
• A change in colour of legs
• Shiny skin on legs
• Loss of hair over legs
• Late presentation is critical limb ischemia and necrosis of the limb which may require amputation(surgical removal of the part from body)

TREATMENT

• Even some patients with severely low blood flow causing gangrene (necrosis) may have their toes or limbs saved by interventional cardiologist by nonsurgical treatments like balloon angioplasty, stent placement through percutaneous procedures.