Arterial insufficiency
| Peripheral artery disease | |
|---|---|
| Synonyms | Peripheral vascular disease (PVD), peripheral artery occlusive disease, peripheral obliterative arteriopathy |
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| An arterial insufficiency ulcer in a person with severe peripheral artery disease | |
| Specialty | Vascular surgery |
| Symptoms | Leg pain when walking which resolves with rest, skin ulcers, bluish skin, cold skin |
| Complications | Infection, amputation |
| Causes | Atherosclerosis, artery spasm |
| Risk factors | Cigarette smoking, diabetes, high blood pressure, high blood cholesterol. |
| Diagnostic method | Ankle-brachial index < 0.90, duplex ultrasonography, angiography |
| Treatment | Stopping smoking, supervised exercise therapy, surgery |
| Medication | Statins, ACE inhibitors, cilostazol |
| Frequency | 155 million (2015) |
| Deaths | 52,500 (2015) |
| Classification |
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| External resources |
Peripheral artery disease (PAD) is a narrowing of the arteries other than those that supply the heart or the brain. When narrowing occurs in the heart, it is called coronary artery disease, while, in the brain, it is called cerebrovascular disease. Peripheral artery disease most commonly affects the legs, but other arteries may also be involved. The classic symptom is leg pain when walking which resolves with rest, known as intermittent claudication. Other symptoms including skin ulcers, bluish skin, cold skin, or poor nail and hair growth may occur in the affected leg. Complications may include an infection or tissue death which may require amputation; coronary artery disease, or stroke. Up to 50% of cases of PAD are without symptoms.
The main risk factor is cigarette smoking. Other risk factors include diabetes, high blood pressure, and high blood cholesterol. The underlying mechanism is usually atherosclerosis. Other causes include artery spasm. PAD is typically diagnosed by finding an ankle-brachial index (ABI) less than 0.90, which is the systolic blood pressure at the ankle divided by the systolic blood pressure of the arm.Duplex ultrasonography and angiography may also be used. Angiography is more accurate and allows for treatment at the same time; however, it is associated with greater risks.
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