Peripheral Artery Disease – Diagnosis and Treatment
Diagnosis
Doctors use a few main ways to check for peripheral artery disease (PAD). The disease develops when atherosclerosis slows blood flow in the arteries.
If you mention leg pain or numbness, your provider will likely start by asking about your medical and family history. They’ll also check for things like weak or missing pulses in your legs, ulcers, shiny skin, or hair loss.
Here are some of the main tests:
Blood Work: Doctors run blood tests to spot risk factors like high cholesterol or blood sugar, which often go hand-in-hand with artery problems.
Ankle-Brachial Index (ABI): This test compares blood pressure at your ankle and arm. If your ankle pressure is lower than your arm, you might have a blocked artery. Sometimes, they’ll have you walk on a treadmill and then check your blood pressure again.
Doppler Ultrasound: Using sound waves, this test shows how blood moves through your leg arteries. It’s good for finding narrowed or blocked spots that cause cramps or claudication.
Angiogram, CT, or MR Angiography: These scans use contrast dye to highlight your blood vessels. They help pinpoint where arteries are narrow or blocked.
Here’s a quick table of common symptoms and which tests match up:
| Symptom | Test Used |
|---|---|
| Painful cramping | ABI, ultrasound |
| Non-healing sores | Angiography, ultrasound |
| Absent pulses | ABI, physical exam |
| Numbness or tingling | Doppler ultrasound |
Treatment
Peripheral artery disease (PAD) comes with several ways to control symptoms and cut down other health risks. Treatments aim to help you walk with less pain and keep your arteries healthier for longer.
Most plans use a mix of medicine and procedures, tailored to what you need.
Medicines Used to Treat PAD
A lot of people with PAD end up taking one or more medicines. These can slow the disease, ease symptoms, and help prevent big issues like heart attacks or strokes.
Types of Medicines:
Cholesterol-Lowering Drugs: Statins cut down “bad” cholesterol. Less cholesterol means less plaque in your vessels, which helps keep arteries open and lowers your risk of heart problems.
Blood Pressure Medications: Keeping blood pressure in check really matters for PAD. These medicines help your arteries stay flexible and make it easier for blood to flow.
Medicines for Diabetes: If you have diabetes, keeping your blood sugar steady is key. Diabetes can make PAD worse, so your doctor will pick the right meds for you.
Antiplatelet Agents: These agents stop platelets from clumping together, which lowers your risk of blood clots.
Treatment for Leg Pain: Vasodilators can help you walk further with less pain by widening your blood vessels.
Surgical and Interventional Treatments
When medicine and lifestyle changes aren’t enough, your doctor might suggest a procedure or surgery to get blood moving better. These options can give faster relief and help prevent long-term damage.
A few examples:
Clot-Busting Therapy (Thrombolytic Therapy): Doctors deliver medicine right into the blocked artery to break up a clot that’s causing sudden trouble.
Artery Widening and Support (Angioplasty and Stenting): Doctors use a small balloon to open up a narrowed artery, and sometimes place a tiny mesh stent to keep it open.
Re-routing Blood Flow (Bypass Graft Surgery): If an artery is really blocked, surgeons create a new path for blood using a healthy vessel from somewhere else in your body.
Atherectomy: This technique actually removes plaque from artery walls using a special device, helping restore blood flow.
Sometimes, you may need more than one treatment, depending on how severe your PAD is and what other health issues you have.
Making Everyday Choices for Managing PAD
Caring for Your Feet
If you have peripheral artery disease, you need to look after your feet closely. Poor blood flow can make it tough for wounds or sores to heal, especially if you also have diabetes.
A daily foot routine really matters.
Wash and Dry Feet Each Day: Clean your feet gently with mild soap and warm water. Dry them well, especially between your toes.
Moisturize, but Avoid Toes: Use unscented lotion on the tops and bottoms of your feet to keep skin from cracking. Don’t put lotion between your toes—too much moisture there can cause fungus.
Wear the Right Socks and Shoes: Thick, dry socks and well-fitting shoes protect you from blisters and sores. Avoid shoes that pinch or rub.
Treat Fungal Infections Promptly: If you spot athlete’s foot or another infection, treat it early to prevent bigger problems.
Check Feet Every Day: Look for cuts, sores, redness, or swelling. If you see anything weird or slow to heal, call your doctor.
Toenail Care: Trim nails straight across and file the edges. If nails are thick or ingrown, let a podiatrist handle it.
Professional Care for Foot Conditions: For bunions, corns, or calluses, see a podiatrist. Don’t try to fix these at home—it can cause injury or infection.
Here’s a simple table for daily foot care:
| Foot Care Step | How Often | Important Tips |
|---|---|---|
| Wash and dry | Every day | Make sure feet are fully dry before socks |
| Moisturize | Daily | Avoid between-toe use |
| Inspect for injuries | Every day | Use a mirror if needed |
| Wear good footwear | Every day | Avoid tight, narrow, or high-heeled shoes |
Staying active, avoiding tobacco, eating well, checking your meds, and even changing how you sit or rest your legs can all help. Small, steady changes really add up when it comes to keeping PAD from getting worse.
If you’re having foot or leg trouble, talk to your doctor or a foot specialist.
Getting Ready for Your Visit
Getting ready for your appointment matters, especially if you have symptoms that might point to PAD. Check if you need to skip food or drinks before certain tests, like cholesterol checks.
Write down all your symptoms—even small ones. Jot down when the pain started, how often it happens, and what makes it better or worse. This helps your doctor get a clearer picture.
Make a list of your past and current health problems, and any family history of heart disease, stroke, diabetes, high cholesterol, or blood pressure. These all raise your risk for PAD, especially if you’re older, overweight, or smoke.
Bring a detailed list of every medicine you take. Include prescriptions, over-the-counter stuff, and supplements, plus dosages. Some medicines, especially for cholesterol or blood pressure, might interact with new treatments.
Bringing a friend or family member makes it easier to remember everything your care team tells you.
Here’s a sample table of questions to ask:
| Question | Why Ask This? |
|---|---|
| What might be causing my symptoms? | Identifies possible links to PAD or other conditions |
| What tests do I need? | Helps prepare for procedures such as cholesterol or blood pressure screening |
| What treatment options do I have? | Understands the choices available and potential side effects |
| How can I lower my risk for complications? | Finds strategies to prevent heart attack or stroke |
| What lifestyle changes should I make? | Addresses ways to improve cholesterol, blood sugar, and blood pressure |
| Can you explain the risks, like heart attack or other cardiovascular events? | Gets clear information on future health |
Having your questions ready means you probably won’t forget something important.
Questions and Information the Doctor May Ask
During your visit, your doctor or vascular specialist will ask when your symptoms started and how they change with activity. Expect questions about whether pain gets worse when you walk or exercise, and if it gets better with rest.
They’ll probably ask about your history with smoking or tobacco, since that’s a huge risk factor for PAD and heart problems. Honest answers help your care team understand all your risks, like high cholesterol, diabetes, obesity, or a family history of heart disease.
Your doctor may also talk about other health issues or medicines that could affect PAD. Open, honest communication helps them give you care that fits your needs and follows the best guidelines.
Actions to Take While Waiting for the Appointment
You can actually do a few things while you wait to see a specialist.
- Stop smoking as soon as possible, if you haven’t already. Smoking really drives PAD and just makes things worse.
- Improve your diet by cutting down on saturated fat and eating more fruits and veggies. That shift can help your cholesterol.
- Manage any existing health problems like high blood pressure, high cholesterol, or diabetes. These issues play a big role in PAD, heart attacks, strokes, and other heart concerns.
- Stay active if your doctor says it’s okay. Even gentle movement can boost your circulation.
Small changes like these might feel tough at first, but they can make a real difference while you’re waiting for your appointment.
