Peripheral Arterial Disease (PAD)

Peripheral Arterial Disease (PAD) is a common condition referring to the restriction of blood flow in the arteries of the leg. This restriction occurs when arteries become narrowed by plaque, which is the accumulation of cholesterol and other substances on the walls of the arteries. An individual with PAD may experience leg pain or cramping when walking, leg numbness or weakness, cold legs or feet, sores that won’t heal on the toes, feet, or legs, and changes in leg color. Typically, symptoms occur when the arteries have already significantly blocked, and if left untreated, PAD can lead to limb-threatening consequences.

PAD is also an indication of more widespread arterial disease, which can affect the heart, causing a heart attack, or the brain, causing a stroke. Therefore, it is crucial to address the condition immediately.

There are several risk factors of PAD that one must consider: being over age 50, smoking (previously or currently), diabetes or high blood sugar levels, high blood pressure, high cholesterol, personal or family history of PAD, heart disease, heart attack, or stroke, and a sedentary lifestyle.

To diagnose PAD, a comprehensive medical history of the patient is obtained, followed by a lower extremity physical examination that includes the evaluation of foot deformities, skin condition, and pulses to determine the patient’s risk for PAD. Further tests may be ordered if risk factors are present.

Several non-invasive tests are generally available to assess PAD. A simple ankle-brachial index (ABI) test measures and compares blood pressure at the arm and ankle levels. An abnormal ABI typically indicates underlying PAD and prompts the foot and ankle surgeon to refer the patient to a vascular specialist for additional testing and treatment, if necessary.

There are several treatments available for PAD. The first approach involves lifestyle changes, such as smoking cessation, eating a heart-healthy diet, and regular exercise. Medication is also another approach that can be used to improve blood flow, prevent blood clots, or control blood pressure, cholesterol, and blood sugar levels. In some cases, small incision (endovascular) procedures or open (bypass) surgery of the leg may be required to improve blood flow.

It is important to note that foot problems such as hammertoes, bunions, or dermatologic conditions such as ingrown, thickened fungal nails become more severe when PAD is present. Since people with PAD do not have normal blood flow in their legs and feet, seemingly small problems such as cuts, blisters, or sores, can result in serious complications. Therefore, routine foot exams and seeking immediate help when changes are noticed can prevent the small issues from worsening.

In conclusion, a proper diagnosis and treatment for PAD are essential in preventing conditions such as heart attack or stroke, as well as improving mobility and reducing complications. Speak to a foot and ankle surgeon, like Dr. Gilbert Huang DPM, to learn more about the best diagnostic and treatment options available.


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