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What is Peripheral Arterial Disease?

What is Peripheral Arterial Disease?

Peripheral Arterial Disease (PAD) is the damage to the arteries that carry blood to the lower limbs by atherosclerosis—that is, the hardening of the artery walls and a reduction in the space within which blood can circulate. This narrowing can be partial, described as "tightening," or total.

This condition results in difficulty in oxygenating the tissues of the lower limbs, namely muscles, nerves and skin.

Patients often first consult a physiatrist or orthopedist, as this problem can be confused, at an early stage, with muscle pain.

Symptoms

Symptoms

  • The patient may complain of pain only while walking or making prolonged physical efforts, such as walking faster or at a steep incline.
    This pain is most common in the calf, but it depends on the location of the blocked artery. It can also be felt in the foot, buttock, hip, or other variable areas.
  • In more severe cases, symptoms vary. The patient may experience pain even at rest, as oxygen levels are severely compromised. In these cases, non-healing wounds or even gangrene may develop in the extremities.
    Gangrene occurs when tissues don't receive enough oxygen to ensure the survival of their constituent cells, which eventually die. This condition is irreversible, and the limb may even be amputated.
Risk Factors

Risk Factors

This disease mainly affects:

  • Smokers
  • Diabetics
  • Hypertensive patients
  • High cholesterol

Peripheral Arterial Disease occurs mostly in men and is more prevalent according to genetic predisposition and family history.

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Treatment of Peripheral Arterial Disease

After a PAD diagnosis, medications should always be used. Furthermore, surgery may or may not be an option, depending on the patient's characteristics and risk factors.

 

Drugs

Antiplatelet drugs that act directly on blood platelets can be considered, as well as statins that have an indirect effect on reducing cholesterol levels and a direct effect on the artery wall, stabilizing atherosclerotic lesions.

Anti-clauditis medications can also be used to increase walking distance in these patients. These medications neither worsen nor improve the severity of the disease; however, they can walk further. This is an advantage, as exercise also has indirect benefits—it helps control diabetes, cholesterol, and blood pressure levels.

Surgeries

There are several revascularization procedures using the open approach, that is, exposing the vessels and operating directly on them.

Endovascular surgeries can also be performed, where an attempt is made to navigate through the occluded area, recanalizing or dilating it. After this action, the procedure is completed by placing a mesh cylinder in that location (stents), which aims to increase the durability of what has been achieved.

There is also the possibility of performing an angioplasty, which consists of dilating the area of the artery that was occluded or stenosed, with balloons impregnated with drugs that are directly delivered to the inner wall of the vessel, reducing the likelihood of that vessel narrowing again.

Specialist Doctor
in Peripheral Arterial Disease

Prof. Doctor Sergio Sampaio

  • Graduated from the Faculty of Medicine of the University of Porto
  • PhD from the Faculty of Medicine of the University of Porto
  • Specialist in Angiology and Vascular Surgery
  • Fellow of the European Board of Vascular Surgery
See Full Biography
Prof. Doctor Sergio Sampaio Prof. Doctor Sergio Sampaio Prof. Doctor Sergio Sampaio Prof. Doctor Sergio Sampaio Prof. Doctor Sergio Sampaio Prof. Doctor Sergio Sampaio Prof. Doctor Sergio Sampaio Prof. Doctor Sergio Sampaio
Prof. Doctor Sergio Sampaio

Frequently Asked Questions about Peripheral Artery Disease

1

How can I prevent Peripheral Arterial Disease?

Combating a sedentary lifestyle helps significantly in preventing this condition, as there are certain indirect effects associated with it. In other words, a person who exercises ends up having better controlled diabetes, blood pressure, and cholesterol levels. These factors are associated with PAD as risk factors.

2

Can patients with an active physical lifestyle have this problem?

Physical exercise is very beneficial in preventing PAD, but it does not prevent it.

Patients who have already been diagnosed with the disease and embrace a more active lifestyle end up having a more favorable outcome, since the use of the lower limbs keeps the circulation pathways open and conditions and accustoms the metabolic mechanisms of the muscles to function with a lower level of oxygenation.

3

If I feel pain while walking, should I stop?

Even though you may feel pain caused by the effort, you should counter it and encourage walking, without fear of walking.

However, you should consult a vascular surgeon to make a diagnosis and understand what type of treatment you should follow to avoid more serious problems associated with Peripheral Arterial Disease.

4

Can wearing tight pants and high heels cause Peripheral Artery Disease?

No, not at all. Wearing tighter clothing or high heels is not associated with PAD.

Clinical note: This page presents general information and uses language appropriate for readers without training in the field. The content was written in accordance with current scientific knowledge on the treatment of Peripheral Arterial Disease and reviewed by Allure Clinic physicians.