Peripheral Artery Disease (PAD) Treatment in Delhi, India
Overview
It commonly affects the lower limbs but can affect any blood vessel such as arms, stomach, head, kidneys. It usually affects the older population but can occur at any age. A warning sign of PAD is having cramps when moving that subsides on taking adequate rest. It can lead to stroke or heart attack if left untreated.
Peripheral artery disease has a high prevalence rate among the population. However, it is one of the most underdiagnosed and undertreated diseases.
Peripheral Artery Disease Symptoms
Most patients experience no symptoms. Owing to compromised blood flow to the lower extremities, a person suffering from PAD may complain of cramps or pain in the legs. This type of pain is claudication. The muscles pain only when in motion. Most affected sites include thighs, buttocks, and calves. The pain subsides when the affected individual rests well. Peripheral Artery Disease Symptoms that indicate an advanced case are as follows:
- Weakness in the legs
- Burning or aching pain in feet at night
- Erectile dysfunction (in diabetic men)
- Fatigue after certain activities such as walking
- Loss of hair on the legs
- Shiny skin of the legs
- Delayed wound healing
- Slow toenail growth
- Changes in the skin such as decreased skin temperature or thin and fragile skin on the legs and feet
Peripheral Artery Disease Causes
Diagnosis & Peripheral Artery Disease Test
Assessment of the symptoms and a physical examination can be expected at the first consultation. The doctor would look for a change in colour of the legs, a whooshing sound in the leg arteries heard over a stethoscope. A weak or absent pulse below the artery, delayed wound healing, and disrupted blood supply to the lower limbs to diagnose it as PAD. To confirm the diagnosis, the doctor might suggest some peripheral artery disease test.
- Blood Tests: Blood tests may be done to check for diabetes and assess cholesterol and triglyceride levels.
- Angiography: An angiography may be performed by injecting a contrasting dye into the arteries to view the blood flow through the arteries. Imaging techniques such as X-rays, magnetic resonance angiography (MRA) or computerized tomography angiography enable the doctor to visualize the flow of the dye. In case a blocked blood vessel is found, an invasive procedure, called catheter angiography may be advised.
- Ultrasound Tests: Doppler ultrasound can help detect any blocks within the arteries.
- Ankle-Branchial Index: It is a common test used to diagnose PAD. This test compares the blood pressure in the ankle with the arm. A regular cuff with a special ultrasound device is used to evaluate the blood pressure.
In case a patient is diagnosed with PAD, the doctor shall formulate a treatment plan based on the needs. They may advise lifestyle changes, prescribe medicines, or advise surgery based on the stage of the disease.
Peripheral Artery Disease Treatment
PAD usually requires only symptomatic treatment unless they prove ineffective and become indicative of surgery. Lifestyle changes such as weight reduction, controlled diabetes, regular exercise, and practicing healthy habits may help prevent the disease altogether. Smoking is an important factor since it helps in the formation of plaques along the blood vessel walls.
A doctor may prescribe medicines to control the symptoms of existing conditions that may worsen PAD, such as diabetes, high blood pressure, and high cholesterol.
Medications for Peripheral Artery Disease
Anti-Hypertensives
In case of high blood pressure, a patient may be at risk of developing cardiovascular disease. The normal range of blood pressure is 120/80 mmHg +- 20/10 mmHg.
Cholesterol-Lowering Drugs
Statin is the drug of choice for reducing cholesterol levels to prevent the risk of heart attack and stroke. Levels of LDL (low-density lipoprotein), the bad cholesterol, should be less than 100 mg/dL for those diagnosed with PAD. These levels need to be lower if one has major risk factors for heart attack and stroke, especially when diabetic and smoking.
Medications for Diabetes
It is imperative to control blood sugar levels in diabetics to prevent further progression of PAD. Also, hyperglycemia contributes to delayed wound healing, controlling its levels may prove fruitful.
Blood Thinners
Blood thinners are medicines that prevent embolism or clotting of blood resulting in increased blood flow through vessels of the lower limbs.
Medicines for Symptomatic Relief
Pain in the limbs is the most common symptom of PAD. It can be treated with analgesics and muscle relaxants in case of cramps
Surgical Options for PAD Treatment
When the above treatment options fail to provide relief, doctors suggest surgeries. These include angioplasty, bypass, or thrombolytic therapy.
Angioplasty
A catheter is used to inflate a balloon within the vessel and flatten the plaque in the artery wall. The artery widens and allows improved blood flow through them. Along with this, a mesh tube may be inserted into the artery to prevent it from collapsing.
Bypass Surgery
An alternative path is created around the blocked artery using a blood vessel from another part of the body or a synthetic vessel may be used. This aids in improving the flow of blood through the vessels.
Thrombolytic Therapy
If a blood clot is obstructing the artery, an anti-platelet or clot-dissolving drug may be injected into the artery at the point of the clot to dissolve it.
Risk Factors After Peripheral Artery Disease Treatment
Smoking, having high blood pressure, high cholesterol or triglyceride levels, diabetes, renal failure, and obesity increase the risk for PAD. Following a healthy lifestyle, cessation of smoking, exercising regularly, following a healthy diet, giving up on alcohol, and maintaining optimum body weight can help prevent the onset of this disease.
Complications of Peripheral Artery Disease
Complications of PAD most often occur due to reduced blood flow or its absence. Resulting complications may include:
- Amputation of the limb
- Poor and delayed wound healing
- Severe pain in the affected extremity
- Limited mobility due to pain and discomfort
- Increased risk of stroke and heart attack
Timely diagnosis and following preventive measures religiously can help treat PAD effectively.
Prognosis or Outlook for Patients
When to See a Doctor for Peripheral Artery Disease
One should speak to a doctor if any of the following is true:
- In case of a family history of peripheral artery disease, high cholesterol, diabetes, stroke, or heart attack.
- Risk of high blood pressure and high cholesterol.
- History of smoking.
- Obesity
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