Peripheral Arterial Disease: A Patient Guide

What is Peripheral Arterial Disease?

Peripheral arterial disease (PAD) is due to atherosclerosis – a progressive disease that involves the hardening and narrowing of the arteries due to a gradual buildup of plaque (fatty deposits). PAD occurs in the arteries outside of the heart (called peripheral arteries). Peripheral arterial disease (PAD) affects millions of people in the United States, most of whom are not aware that they have the disease. PAD interferes with lifestyle by decreasing walking ability, and slowing healing to the affected areas. As blood flow and therefore oxygen supply progress, the affected area becomes less able to cope with the activities of ordinary everyday life, more amenable to scratches, infections, and eventually to cell death (gangrene).

Atherosclerosis affects the whole body, and people with PAD also have a markedly increased risk of heart attack, stroke and death. A patient with PAD has about five times the risk of dying of a heart attack or stroke over the next ten years as the patient who does not have peripheral arterial disease. Long term risk of patients with peripheral arterial disease is worse than patients with only coronary artery disease.

Which arteries are most affected by PAD?

The major areas where atherosclerosis produces symptoms in the peripheral artery beds are:

  • Cerebrovascular, or brain arteries (e.g., carotid and vertebral arteries) – Cerebrovascular disease (including carotid artery disease) is the leading cause of stroke and disability in the United States.
  • Renal, or kidney arteries – Renal artery stenosis (PAD of the renal arteries) is a major cause of high blood pressure and renal failure requiring dialysis or transplant.
  • Lower extremity, or leg arteries – Lower extremity PAD is a major cause of diminished ability to walk. Advanced cases lead to gangrene, ulcers and amputation of the feet or legs.
  • Mesenteric, or intestinal arteries – Mesenteric arterial disease (PAD of the mesenteric arteries) is less common but can cause severe pain, weight loss, and even death from intestinal gangrene.
  • Abdominal aorta – Weakening of the wall of this major vessel that leads to the lower extremities can result in aneurysm, renal failure, gangrene, ulcer, amputation and the problems of mesenteric and intestinal artery blockage.

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