Peripheral Arterial Occlusive Disease

What is peripheral arterial occlusive disease?

Peripheral arterial occlusive disease is a type of atherosclerosis, a hardening and narrowing of the arteries that supply blood to the arms and legs. In most cases, it affects the legs. Problems result when blood flow to the extremities is severely reduced.

Risk factors

This disease is caused by a condition called atherosclerosis. Commonly known as hardening of the arteries, atherosclerosis is caused by a build-up of cholesterol and calcium deposits on the inside walls of the arteries. These deposits are called plaques. The plaques may eventually become so thick that they completely block the flow of blood through the arteries.

You are at a higher risk for developing peripheral arterial occlusive disease if you smoke cigarettes, are diabetic, have high blood cholesterol levels, high blood pressure, or a genetic tendency toward it.

Symptoms

This disease progresses silently, without symptoms, until the arteries have become significantly narrowed.

The first symptom is usually pain in the legs when walking or exercising. As the narrowing worsens, so does the pain. One or both legs may be affected and pain may also be felt in the thighs or buttocks. This pain usually occurs with exertion, quickly goes away when you rest, and returns when you are active again. Your feet may seem cooler. If you had hair on the top of your feet, you may notice some hair loss. Cuts and scrapes take longer to heal.

Diagnosis

Your health care provider will examine you and ask about your symptoms and medical history. Pulses should be checked in your feet, legs, and groins. If your pulse exam is abnormal, physiologic (pressures and waveforms), or direct imaging with ultrasound may be performed to identify the location and degree of arterial narrowing. Other special x-rays, such as an arteriogram may be required.

Treatment

Risk factors must be eliminated, as much as possible. If you smoke, stop! Medications should be taken as needed to reduce your blood pressure or lower the level of fats in your blood. Changes in diet may be necessary. Exercise is vital to improving and maintaining good arterial circulation.

Not all blockages require a procedure. However, procedures to improve your circulation may be required for significant blockages. The treatment choices include:

  1. Removing the blocked portion of the artery.
  2. Creating a bypass using a piece of vein or synthetic material.
  3. Catheterization and balloon dilation, where a small tube is inserted into an artery in the groin and a small balloon at the tip of the catheter is inflated to widen the blocked area of the artery. If your disease is extremely severe or surgery is not possible, amputation of a leg or foot may become necessary. Amputation is a last resort, but if peripheral arterial occlusive disease is not controlled, it is a possible complication.

How do I take care of myself?

Follow your health care provider's instructions on diet, exercise, and medications. If you smoke, stop! See your health care provider immediately if your symptoms become more severe or you develop a foot ulcer.

What can be done to prevent peripheral arterial occlusive disease?

The best way is to maintain all-around fitness. Try to reach and maintain a normal weight, blood pressure, and levels of fats and sugar in your blood. Eat a healthy diet. Exercise 3-4 times a week, walking or cycling for 20 minutes or more each time, as long as you do not experience chest pain or shortness of breath. Be sure to consult with your health care provider before starting a more vigorous exercise program.