Peripheral Artery Disease (PAD)Treatment in Gurgaon, India
What is Peripheral Artery Disease?
Peripheral Artery Disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs, primarily the legs. PAD occurs when the arteries that supply blood to the arms and legs become constricted or blocked due to plaque buildup, leading to reduced oxygen and nutrient delivery to tissues and organs. This condition can cause significant pain and, if left untreated, can result in serious complications, including limb amputation.
What are the Symptoms of Peripheral Artery Disease?
Peripheral Artery Disease (PAD) can present a range of symptoms, though in the early stages, some individuals may not experience any noticeable signs. When symptoms do occur, they are often related to reduced blood flow in the legs and feet. The most common peripheral artery disease symptoms include:
Leg Pain or Cramping (Intermittent Claudication)
One of the hallmark symptoms of PAD is pain, cramping, or aching in the legs, particularly during physical activities like walking or climbing stairs. The pain often subsides with rest but may return after exertion.
Numbness or Weakness in the Legs
As PAD worsens and blood flow continues to decrease, you may experience a feeling of weakness or numbness in the legs, making it difficult to walk or stand for long periods.
Coldness in the Lower Leg or Foot
Poor circulation in the legs can cause them to feel unusually cold, especially compared to the other leg. This occurs because the reduced blood flow prevents the legs from maintaining normal temperature regulation.
Shiny or Pale Skin on the Legs
Reduced blood supply can cause changes in the skin’s appearance, making it look pale or shiny. In severe cases, the skin may also appear dry and thin.
Slow or Non-Healing Wounds/Ulcers on the Legs and Feet
One of the more serious symptoms of PAD is the development of wounds or sores that take a long time to heal or do not heal at all. This happens because the blood flow to the affected area is insufficient to support healing.
Loss of Hair on the Legs and Feet
The decreased circulation can lead to hair loss on the legs and feet, as hair follicles require a steady supply of oxygen and nutrients to grow.
Decreased Pulse in the Legs or Feet
In individuals with PAD, the pulse in the feet or legs may be weak or difficult to detect. This is due to the narrowing or blockage of the arteries that supply blood to these areas.
Discoloration of the Legs
The skin on the legs or feet may develop a reddish or bluish tint due to poor oxygen supply, particularly when the leg is elevated.
In advanced stages of PAD (known as critical limb ischemia), individuals may experience persistent pain in the legs, even when at rest. This pain often occurs at night and can be severe.
How is Peripheral Artery Disease Caused?
Peripheral Artery Disease (PAD) is mainly caused by atherosclerosis, which is the buildup of fatty deposits (plaque) on the walls of arteries, narrowing them and restricting blood flow. Several peripheral artery disease causes and risk factors contribute to the development of this condition. Peripheral Arterial Disease Risk Factors:
PAD is more common in individuals over 50.
Smoking is a major contributor to PAD as it damages the blood vessels.
High blood sugar levels can damage the blood vessels, leading to PAD.
Elevated cholesterol can increase plaque buildup in the arteries.
Increases the risk of plaque development and narrows arteries.
Being overweight or obese can strain the cardiovascular system.
Genetics can play a role in the development of PAD.
Lack of physical activity can contribute to the development of PAD.
What are the Stages of Peripheral Artery Disease?
Peripheral artery disease is often categorized into stages of PAD to understand the severity of the condition. The stages range from mild to severe:
No symptoms, but blood flow is reduced in the affected arteries.
Pain and cramping in the legs occur with physical activity (intermittent claudication).
Pain in the legs, even when at rest, indicating severe artery narrowing.
Stage 4 (Ulceration or Gangrene)
Tissue death or non-healing ulcers occur, often requiring surgical intervention.
When to See a Cardiologist for Peripheral Artery Disease?
If you experience symptoms like leg pain, numbness, or wounds that do not heal, it’s essential to seek medical advice. Early diagnosis can help prevent severe complications such as limb amputation. Peripheral artery disease diagnosis is confirmed through clinical tests like ABI (Ankle-Brachial Index) and vascular ultrasounds.
How is Peripheral Artery Disease Diagnosed?
Diagnosing PAD typically involves several tests to assess the flow of blood to the legs and feet:
Ankle-Brachial Index (ABI)
This simple, non-invasive test compares the blood pressure in your ankle to the blood pressure in your arm. A low ABI indicates poor blood flow to the legs.
Pulse Volume Recording (PVR)
This test measures changes in blood volume in the limbs to assess the degree of arterial blockage.
A vascular ultrasound uses sound waves to visualize the blood vessels and identify any blockages or narrowing.
What are the Treatment Methods for Peripheral Artery Disease?
Treatment for Peripheral Artery Disease (PAD) focuses on improving blood flow to the affected limbs, relieving symptoms, preventing complications, and reducing the risk of further cardiovascular events such as heart attack or stroke. Depending on the severity of PAD, treatment options can range from lifestyle changes to more advanced medical or surgical interventions. Below are the primary PAD treatment methods:
Making healthy lifestyle changes is the first line of defence in managing PAD and can significantly improve symptoms and quality of life.
Regular physical activity, especially walking, helps improve blood flow and build up tolerance to walking longer distances without pain. A supervised exercise program can also help increase walking distance in those with intermittent claudication.
Eating a heart-healthy diet low in saturated fats, cholesterol, and sodium can help reduce plaque buildup in the arteries. Focus on a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats like omega-3s.
Smoking is a major risk factor for PAD. Quitting smoking improves circulation, reduces further arterial damage, and decreases the risk of complications.
Maintaining a healthy weight through diet and exercise reduces strain on the cardiovascular system and helps manage diabetes, cholesterol, and blood pressure.
Blood Pressure and Diabetes Control
If you have high blood pressure or diabetes, managing these conditions is critical in slowing the progression of PAD and preventing additional complications.
Medications can help alleviate symptoms, improve circulation, and prevent blood clots, reducing the risk of heart attacks and strokes.
Certain medications can help prevent blood clots by thinning the blood. These medications reduce the likelihood of blockages worsening or causing heart attacks.
Cholesterol-Lowering Statins
Statins, such as atorvastatin or simvastatin, lower cholesterol levels and slow the progression of atherosclerosis by reducing plaque buildup in the arteries.
Angiotensin-converting enzyme (ACE) Inhibitors
ACE inhibitors can help control high blood pressure and may help improve blood flow to the limbs in some cases of PAD.
Supervised Exercise Programs
Supervised exercise programs are an essential part of PAD treatment. These programs typically consist of walking exercises, designed to improve leg strength, increase endurance, and reduce the pain associated with intermittent claudication. Studies have shown that regular walking under the supervision of a cardiologist can significantly improve walking distance and general quality of life.
Minimally Invasive and Surgical Treatments
In more advanced cases of PAD, where lifestyle changes and medications are not enough to restore sufficient blood flow, the cardiologist may recommend surgical procedures like:
Angioplasty and Stent Placement (Percutaneous Transluminal Angioplasty, PTA)
In angioplasty, a catheter with a balloon is inserted into the blocked artery, and the balloon is inflated to widen the artery. A stent may be placed to keep the artery open, allowing blood to flow more freely.
In cases where arteries are severely blocked, bypass surgery may be required. In this procedure, a healthy blood vessel from another part of the body (or a synthetic graft) is used to bypass the blocked or narrowed artery, restoring blood flow to the affected leg.
In an endarterectomy, a surgeon removes plaque buildup from the walls of the artery to restore blood flow. This procedure is more commonly done in larger arteries such as the femoral artery.
In certain cases, thrombolytic therapy may be used to break up blood clots that are obstructing blood flow in the arteries. This is often done with medication that dissolves clots (thrombolytics) and is typically used in acute situations.
Amputation (in Severe Cases)
For individuals with critical limb ischemia or non-healing wounds, amputation may be necessary if the tissue in the limb dies due to a lack of blood flow. This is a last-resort measure, and efforts are always made to avoid it through other interventions.
How to Prevent Peripheral Arterial Disease?
While it may not always be possible to completely prevent Peripheral Artery Disease (PAD), adopting healthy lifestyle habits can significantly reduce your risk of developing it. PAD is often linked to atherosclerosis, which is the buildup of fatty deposits in the arteries, leading to reduced blood flow. Many of the risk factors for PAD are preventable or manageable with lifestyle changes and medical intervention. Here are some effective ways to help prevent PAD:
Smoking is one of the leading risk factors for PAD, as it damages the blood vessels and accelerates the development of atherosclerosis. The toxins in cigarette smoke cause inflammation and thickening of the blood vessels, which restricts blood flow. Quitting smoking is one of the most effective ways to prevent PAD and improve overall cardiovascular health.
Regular physical activity is crucial in preventing PAD. Exercise helps improve blood circulation, strengthen the heart, and maintain healthy blood vessels. Aim for at least 30 minutes of moderate exercise most days of the week, such as walking, cycling, or swimming. For individuals at risk or with early PAD, supervised exercise programs can help improve circulation and reduce the progression of the disease.
Maintain a Healthy Weight
Being overweight or obese increases the strain on the cardiovascular system and raises the risk of developing high blood pressure, diabetes, and high cholesterol—all of which are risk factors for PAD. Maintaining a healthy weight through a balanced diet and regular exercise can significantly lower the likelihood of developing PAD.
A heart-healthy diet plays a key role in reducing the risk of atherosclerosis and PAD. Focus on eating:
Fruits and vegetables: Rich in antioxidants, vitamins, and fiber.
Whole grains: High in fiber, which can help lower cholesterol.
Lean proteins: Such as fish, poultry, and plant-based proteins.
Healthy fats: Opt for sources of unsaturated fats like olive oil, nuts, and avocados, while reducing saturated fats and trans fats.
Limiting sodium intake and avoiding processed foods high in salt, sugar, and unhealthy fats will help keep blood pressure and cholesterol levels in check.
Control Your Blood Pressure
High blood pressure (hypertension) is a major risk factor for PAD. Uncontrolled hypertension can damage the blood vessels over time, increasing the likelihood of plaque buildup and narrowing of the arteries. Monitor your blood pressure regularly and work with your doctor to keep it in a healthy range (generally below 130/80 mmHg). If you have high blood pressure, lifestyle changes and medications can help control it.
Diabetes increases the risk of PAD because high blood sugar can damage blood vessels and lead to atherosclerosis. If you have diabetes, it’s essential to manage your blood sugar levels through proper diet, exercise, and, if necessary, medication. Regular monitoring of blood sugar levels and working with a cardiologist can prevent or delay the onset of PAD in people with diabetes.
Control Cholesterol Levels
High cholesterol is a major contributing factor to the development of PAD. High levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol increase plaque buildup in the arteries. A cholesterol-friendly diet, regular exercise, and medications such as statins can help maintain healthy cholesterol levels and reduce the risk of PAD.
Regular health checkups are crucial, especially if you are at higher risk of PAD. Your doctor can monitor your blood pressure, cholesterol levels, blood sugar, and general cardiovascular health. Early detection of risk factors and treatment can significantly reduce your risk of developing PAD.
Limit Alcohol Consumption
Excessive alcohol consumption can increase the risk of high blood pressure, diabetes, and obesity, all of which are risk factors for PAD. Limiting alcohol intake to moderate levels (up to one drink per day for women and two drinks per day for men) can reduce your overall risk.
Choose Artemis Hospitals for Peripheral Artery Disease Treatment in Gurgaon
To book an appointment with the top cardio surgeons for peripheral artery disease treatment at Artemis Hospitals, call our customer care at +91-124-451-1111 or WhatsApp us at +91 9599285476. You can also schedule an appointment through our online patient portal or download and register on the Artemis Personal Health Record mobile app, available for both iOS and Android devices.
Reviewed By Dr. Amit Kumar Chaurasia
Chief Cath Lab & TAVI (Unit I)
Artemis Hospitals
Frequently Asked Questions
Can Peripheral Artery Disease be cured?
While there is no complete cure, PAD can be managed effectively with lifestyle changes, medication, and, in some cases, surgical treatment.
What is the first sign of PAD?
The first sign of PAD is often pain or cramping in the legs during physical activity, known as intermittent claudication.
How do I know if I have PAD?
If you experience leg pain, numbness, or slow-healing wounds, consult a doctor. Tests like ABI and vascular ultrasounds can diagnose PAD.
Can PAD cause a heart attack?
Yes, PAD is a risk factor for heart attack and stroke because it is caused by atherosclerosis, which affects the coronary arteries as well.
Is there a specific diet for PAD?
A heart-healthy diet, rich in fruits, vegetables, and whole grains, and low in saturated fats, can help manage PAD.
What is the difference between PAD and PVD?
PAD (Peripheral Artery Disease) refers specifically to the narrowing of arteries in the limbs, whereas PVD (Peripheral Vascular Disease) includes diseases affecting both the arteries and veins.
What Are Complications of Peripheral Artery Disease?
Left untreated, PAD can lead to several complications, including:
Critical limb ischemia: A severe blockage of the arteries leads to the loss of limb function and possibly amputation.
Heart attack and stroke: PAD increases the risk of heart disease and stroke due to the same atherosclerotic process affecting the arteries.
Non-healing wounds and infections: Due to poor blood flow, wounds on the legs and feet may not heal and can become infected.
Can PAD be reversed?
PAD cannot be fully reversed, but symptoms can be alleviated and progression slowed through treatment and lifestyle changes.
How can I increase blood circulation in my legs?
Regular exercise, elevating the legs, and avoiding prolonged sitting or standing can help improve blood circulation.
