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Peripheral Artery Disease (PAD): Symptoms, Causes and Treatment

By definition, we refer to peripheral artery disease when the body’s blood vessels are narrowed. This means they shrink the size of their inner passage by decreasing the flow of blood through them.

Think of blood vessels as blood transport tubes. These tubes have a certain caliber, that is, a certain internal passage that constitutes their diameter. If that diameter decreases, then we’re looking at peripheral artery disease.

To be more specific, we need to clarify that the diagnosis of this condition takes place when the affected blood vessels are the large arteries of the human body that aren’t in the heart, the aortic system, or the brain. Mainly, this disease affects the arteries of the limbs.

Whether the origin comes from atherosclerosis, thrombus formation, or inflammatory processes, the result is always the same. The effect of arterial obstruction is the production of ischemia, that is, the lack of blood supply to a part of the body.

As for the distribution of peripheral arterial disease, we know that it affects approximately twelve percent of the population. The older the age the greater the prevalence, reaching up to twenty percent in people over seventy.

Unfortunately, it can remain asymptomatic in most of those who experience this disease. Up to eighty percent of those who suffer from it find out when it’s too late and irreversible damage has already taken place. Therefore, both patients and doctors must know what it is and how to recognize it.

Causes of Peripheral Arterial Disease

The main and quintessential cause of peripheral arterial disease is atherosclerosis. This is the formation of fatty plaques on the walls of the arteries, which reduces their internal diameter, allowing less blood flow.

The most common place for these plaques to appear is in the legs. When the blood flow in the lower limbs decreases, symptoms characteristic of the disease develops, which we will name later. What’s more, it evolves without treatment, the tissues can die from lack of oxygen and nutrients.

Experts have identified risk factors which, if present in an individual, increase the possibility of forming atherosclerosis. These factors are:

  • Smoking
  • Aging
  • Diabetes
  • High cholesterol levels
  • Arterial hypertension

There’s also a substance that scientific studies link to peripheral arterial disease: Homocysteine. It’s a part of the proteins that participate in different metabolic processes.

Homocysteine could cause failures in the function of the internal layer of the arteries, preventing it from protecting itself from circulating cholesterol. Because of this, it could increase the formation of fatty plaques and the risk of creating clots, which are also capable of interrupting blood flow.


The classic sign of peripheral arterial disease is intermittent claudication, which doctors have long described. This is the appearance of pain when walking, located in the calf, which forces you to have to stop walking. The pain disappears when you rest.

If the condition evolves, then patients will experience pain not only while walking but also while at rest. This is a serious sign of disease progression. It can even appear at night, interrupting sleep and forcing patients to wake up.

Other symptoms of the disease are:

  • Heaviness in the legs: A sensation of tiredness in the muscles of the limbs.
  • Weak pulse: Mainly in the lower limbs.
  • Wounds and skin ulcers: Of progressive appearance, but slow to heal.
  • Changes in skin color: Legs may become pale or blue.
  • Cooling: One leg colder than the other, for example.
  • Poor growth of skin appendages: Toenails or leg hairs may become brittle and grow more slowly.
  • Erectile Dysfunction: Males may have difficulty achieving or maintaining an erection.

Treatment of peripheral vascular disease

There are three approaches to treating peripheral vascular disease: Lifestyle changes, medication, and surgery. In some cases, changes in habits alone are sufficient. However, other times, medication needs to be added to the treatment plan. What’s more, severe cases may require surgery.

Lifestyle modifications involve quitting smoking if you’re a smoker. This is the main measure. Physical activity and a varied and healthy diet are the ideal complement. For those who suffer from high blood pressure or diabetes, the recommendations for those diseases apply.

As far as medicines are concerned, the treating professional can prescribe the patient drugs that prevent the formation of blood clots, such as aspirin. Cilostazol and pentoxifylline are also used, whose function is to improve blood flow, especially when the symptom of intermittent claudication already exists.

Finally, the last option is surgery. It’s reserved for serious cases and consists of three techniques that the professional will choose according to the clinical picture:

  • Angioplasty: In this case, a catheter is inserted up to the affected artery to inflate a balloon there that reopens the obstructed area.
  • Bypass: A graft is used with a blood vessel from another part of the body or with artificial tissue so that the blood can bypass the blockage using a sort of bridge.
  • Thrombolytic drugs: Here, a medication is injected directly into the artery to dissolve clots.


Peripheral arterial disease originates when the body’s blood vessels become narrowed due to the formation of fatty plaques on the artery walls. Although initially asymptomatic, over time it can cause serious health complications.

For this reason, it’s important to receive a diagnosis and treatment promptly.

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