Peripheral Arterial Disease (P.A.D.)

What is Peripheral Arterial Disease?

Commonly referred to as “poor circulation,” Peripheral Arterial Disease (P.A.D.) is the restriction of blood flow in the arteries of the leg. When arteries become narrowed by plaque (the accumulation of cholesterol and other materials on the walls of the arteries), the oxygen-rich blood flowing through the arteries cannot reach the legs and feet.

The presence of P.A.D. may be an indication of more widespread arterial disease in the body that can affect the brain, causing stroke, or the heart, causing a heart attack.

Signs and Symptoms

Most people have no symptoms during the early stages of P.A.D. Often, by the time symptoms are noticed, the arteries are already significantly blocked.

Common symptoms of P.A.D. include:

·     Leg pain (cramping) that occurs while walking (intermittent claudication)

·     Leg pain (cramping) that occurs while lying down (rest pain)

·     Leg numbness or weakness

·     Cold legs or feet

·     Sores that won’t heal on toes, feet, or legs

·     A change in leg color

·     Loss of hair on the feet and legs

·     Changes in toenails—color and thickness

If any of these symptoms are present, it is important to discuss them with a foot and ankle surgeon. Left untreated, P.A.D. can lead to debilitating and limb-threatening consequences.

Risk Factors of P.A.D.

Because only half of those with P.A.D. actually experience symptoms, it is important that people with known risk factors be screened or tested for P.A.D.

The risk factors include:

·     Being over age 50

·     Smoking (currently or previously)

·     Diabetes

·     High blood pressure

·     High cholesterol

·     Personal or family history of P.A.D., heart disease, heart attack, or stroke

·     Sedentary lifestyle (infrequent or no exercise)

Diagnosis of P.A.D.

To diagnose P.A.D., the Doctors at Hosey Foot and Ankle Centers obtain a comprehensive medical history of the patient. The surgeon performs a lower extremity physical examination that includes evaluation of pulses, skin condition, and foot deformities to determine the patient’s risk for P.A.D. If risk factors are present, our Doctors may order further tests.

Several non-invasive tests are available to assess P.A.D. The ankle-brachial index (ABI) is a simple test in which blood pressure is measured and compared at the arm and ankle levels. An abnormal ABI is a reliable indicator of underlying P.A.D. and may prompt the our Doctors to refer the patient to a vascular specialist for additional testing and treatment as necessary.