Peripheral Arterial Disease

Peripheral Artery Disease (PAD) and leg pain
Most people believe that pain in their legs or calves is the result of a bone or joint disorder or possibly a problem with the nervous system. Some even think that it is normal condition for the elderly, especially when walking or exercising. Actually, the pain can be a direct cause of a blockage or thrombosis to the peripheral arteries.

What are peripheral arteries?
Peripheral arteries are red blood vessels that support many parts of our body, except in heart and brain; these arteries include those in our arms, legs, hands, feet, kidneys or abdomen. They support our muscular, bone and nervous systems and are as important as coronary arteries.

How does peripheral artery disease occur?
Peripheral artery disease is caused by the blockage or thrombosis of the arteries due to the risk factors such as hypertension, diabetes, high blood cholesterol level, smoking, obesity or aging. These factors all have an effect on the abnormality of peripheral arteries.

     • Pain in legs or calves, especially when walking or during exercise
     • Foot cramp or cold feet
     • Wounds on the feet or heels that heal slower than normal. This symptom is mostly found in diabetic patients. In some cases the wounds can turn to gangrene.

These symptoms can happen to one or both side of the body

How to diagnose this disease?
It is important to diagnose peripheral artery disease early on, as it will not only help to stop the symptoms, but also in preventing coronary and cerebral artery diseases.

Peripheral artery disease can be easily diagnosed by the measurement of the rigidity of the arteries in the arms compared to those in the ankles by using ABI ( Ankle Brachial Pressure Index)

ABI is the ratio between Systolic blood pressure in the ankle compared to systolic blood pressure in the arm (and on the same side of the body). The normal ABI is 1. This means that the pressure in the leg artery is equal or higher than the pressure in the arm artery. If it is less than 1, it means that there may be a blockage or thrombosis of that peripheral artery. This technique is easy and convenient and is used for the preliminary diagnosis of patients.

If the physician requires further investigation, a 64-Sliced CT Scan or MRI may be used to assist the diagnosis. However, the most accurate and precise method of diagnosis is Angiogram.

Choices of treatment
This depends on the site and severity of the blockage. The treatments vary from medicine to rehabilitation exercise. In more severe cases, the treatments may be the balloon technique or placing a stent. In the most severe and complicated cases, the patient may need to operate in order to eliminate the blockage. ITM

How to avoid this disease?
Patients must try to avoid all high risk factors such as smoking, diabetes, high cholesterol and high or low blood pressure and take regular exercise. For the elderly, cycling and walking are a good option. Patients should aim to exercise around 30 minutes a day, three times a week and they should exercise continuously for at least 6 months. If the pain in legs or calves occurs when walking or exercising, the patients must see the physician immediately.