Peripheral Artery Disease (PAD)

PAD refers to cholesterol blockage formation (atherosclerosis) within the walls of the vessels in the arms, legs, neck (carotid arteries), aorta (the large vessel which runs from the heart to the abdomen) or any artery outside of the heart.

Patients with PAD are 5-6 fold more likely to have a heart attack than those who do not. PAD can also include aneurysm formation in arteries of the body as well.

Symptoms

• Symptoms of PAD vary by the location of the disease and whether it involves blockages or aneurysms.
• In patients with aneurysms, they are often asymptomatic (no symptoms.) However as the aneurysm enlarges, it can cause pressure. If the layers of the artery tear (dissection), then it may cause a tearing pain.
• In patients with blockage in the arteries of the extremities it can cause pain with activity (claudication.) If there is blockage within the arteries in the neck, it can cause stroke. If there is blockage in the arteries in the abdomen, it can lead to intestinal angina (mesenteric ischemia) which usually presents as pain with eating.

Diagnostic Tests

• Vascular Ultrasound
• Ankle-Brachial Index
• Segmental Pressures

Treatment

• All patients need control of their blood pressure, cholesterol and blood sugars.
• In most patients, there may be benefit to adding clopidogrel (Plavix) to prevent blood clots and further obstruction to blood flow in the arteries.
• Occasionally patients may need angiogram or stent to improve blood flow if there is blockage. In the case of aneurysms, many times these can be repaired with a catheter procedure, however occasionally this may require surgical repair.

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For Additional Information

• Cardiovascular Disorders
• Managing Heart Disease