Question

What are the problems, how it's diagnosed, symptoms and treatments of Peripheral Artery disease?

Answer 1

Peripheral artery disease
Also called: peripheral vascular disease

The most common symptom of peripheral artery disease is intermittent claudication, manifested by pain (usually in the calf) that occurs while walking and dissipates at rest. Doctors may use radiologic imaging techniques including Doppler ultrasound and angiography to aid in the diagnosis of peripheral artery disease.

A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs.
Peripheral vascular disease is a sign of fatty deposits and calcium building up in the walls of the arteries (atherosclerosis). Risk factors include ageing, diabetes and smoking.

Requires a medical diagnosis
Symptoms may include leg pain, particularly when walking.
People may experience:
Pain areas: in the buttocks
Pain circumstances: can occur in the leg and improved with rest or in the leg while exercising
Skin: cool skin, loss of hair on the legs, thinning of skin on the legs, or ulcers

Physical exercise
Aerobic activity for 20–30 minutes 5 days a week improves cardiovascular health. If injured, pursuing an activity that avoids the injured muscle group or joint can help maintain physical function while recovering.
Quitting smoking
Quitting smoking tobacco.
Heart-Healthy diet
A broad category of diets that reduce fat, sugar and red meat while increasing fruits, vegetables, white meat and fish.

Statin
Decreases the liver's production of harmful cholesterol.
Vasodilator
Widens blood vessels.
Anticoagulant
Unwanted reactions from taking drugs that inhibit blood clotting. The most common problem is too much bleeding, which can be very

Angioplasty
Unblocking an artery by inflating a balloon inside it. A stent may also be inserted to hold the artery open.

Treatment consists of self care and blood thinners
Tobacco cessation, exercise and a healthy diet are often successful treatments. When these changes aren't enough, medication or surgery can help.
Self-care
Physical exercise, Quitting smoking and Heart-Healthy diet
Medications
Statin, Vasodilator and Anticoagulant
Medical procedure
Angioplasty

Diagnosis
Some of the tests your doctor may rely on to diagnose peripheral artery disease are:

Physical exam. Your doctor may find signs of PAD during a physical examination, such as a weak or absent pulse below a narrowed area of your artery, whooshing sounds (bruits) over your arteries that can be heard with a stethoscope, evidence of poor wound healing in the area where your blood flow is restricted, and decreased blood pressure in your affected limb.
Ankle-brachial index (ABI). This is a common test used to diagnose PAD. It compares the blood pressure in your ankle with the blood pressure in your arm.

To get a blood pressure reading, your doctor uses a regular blood pressure cuff and a special ultrasound device to evaluate blood pressure and flow.

You may walk on a treadmill and have readings taken before and immediately after exercising to capture the severity of the narrowed arteries during walking.

Ultrasound. Special ultrasound imaging techniques, such as Doppler ultrasound, can help your doctor evaluate blood flow through your blood vessels and identify blocked or narrowed arteries.

Angiography. Using a dye (contrast material) injected into your blood vessels, this test allows your doctor to view blood flow through your arteries as it happens. Your doctor is able to trace the flow of the contrast material using imaging techniques, such as X-ray imaging or procedures called magnetic resonance angiography (MRA) or computerized tomography angiography (CTA).

Catheter angiography is a more invasive procedure that involves guiding a catheter through an artery in your groin to the affected area and injecting the dye that way. Although invasive, this type of angiography allows for simultaneous diagnosis and treatment. After finding the narrowed area of a blood vessel, your doctor can then widen it by inserting and expanding a tiny balloon or by administering medication that improves blood flow.

Blood tests. A sample of your blood can be used to measure your cholesterol and triglycerides and to check for diabetes.

Treatment
Treatment for peripheral artery disease has two major goals:

Manage symptoms, such as leg pain, so that you can resume physical activities
Stop the progression of atherosclerosis throughout your body to reduce your risk of heart attack and stroke
You may be able to accomplish these goals with lifestyle changes, especially early in the course of peripheral artery disease. If you smoke, quitting is the single most important thing you can do to reduce your risk of complications.

If you have signs or symptoms of peripheral artery disease, you likely will need additional medical treatment. Your doctor may prescribe medicine to prevent blood clots, lower blood pressure and cholesterol, and control pain and other symptoms.

Medications
Cholesterol-lowering medications. You may take a cholesterol-lowering drug called a statin to reduce your risk of heart attack and stroke.

The goal for people who have peripheral artery disease is to reduce low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol, to less than 100 milligrams per deciliter (mg/dL), or 2.6 millimoles per liter (mmol/L). The goal is even lower if you have additional major risk factors for heart attack and stroke, especially diabetes or continued smoking.

High blood pressure medications. If you also have high blood pressure, your doctor may prescribe medications to lower it.

A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The top number in the reading measures the pressure in your arteries when your heart beats (systolic pressure). The bottom number in the reading measures the pressure in your arteries between beats (diastolic pressure).

Your blood pressure treatment goal should be less than 130/80 mm Hg. This is the guideline for anyone with coronary artery disease, diabetes or chronic kidney disease. Achieving 130/80 mm Hg is also the goal for healthy adults age 65 and older and healthy adults younger than age 65 with a 10 percent or higher risk of developing cardiovascular disease in the next 10 years.

Medication to control blood sugar. If you also have diabetes, it becomes even more important to control your blood sugar (glucose) levels. Talk with your doctor about what your blood sugar goals are and what steps you need to take to achieve these goals.
Medications to prevent blood clots. Because peripheral artery disease is related to reduced blood flow to your limbs, it's important to improve that flow.

Your doctor may prescribe daily aspirin therapy or another medication, such as clopidogrel (Plavix).

Symptom-relief medications. The drug cilostazol increases blood flow to the limbs both by keeping the blood thin and by widening the blood vessels. It specifically helps treat symptoms of claudication, such as leg pain, for people who have peripheral artery disease. Common side effects of this medication include headache and diarrhea.

An alternative to cilostazol is pentoxifylline. Side effects are rare with this medication, but it’s generally less effective than cilostazol.

Angioplasty and surgery
Graft bypass for peripheral artery disease
Graft bypass Open pop-up dialog box
In some cases, angioplasty or surgery may be necessary to treat peripheral artery disease that's causing claudication:

Angioplasty. In this procedure, a small hollow tube (catheter) is threaded through a blood vessel to the affected artery. There, a small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow.

Your doctor may also insert a mesh framework called a stent in the artery to help keep it open. This is the same procedure doctors use to open heart arteries.

Bypass surgery. Your doctor may create a graft bypass using a vessel from another part of your body or a blood vessel made of synthetic (man-made) fabric. This technique allows blood to flow around — or bypass — the blocked or narrowed artery.
Thrombolytic therapy. If you have a blood clot blocking an artery, your doctor may inject a clot-dissolving drug into your artery at the point of the clot to break it up.
Supervised exercise program
In addition to medications or surgery, your doctor likely will prescribe a supervised exercise training program to increase the distance you can walk pain-free. Regular exercise improves symptoms of PAD in a number of ways, including helping your body use oxygen more efficiently.