What is Peripheral Vascular Disease?

Yes. PAD is a condition similar to coronaryartery disease and carotid artery disease.(Coronary artery disease is the name for fattybuildups in the arteries that supply the heartmuscle with blood and nourishment. Carotidartery disease is the name for fatty buildups inthe neck artery that brings blood to the brain.)

In PAD, fatty deposits build up in the innerlining of artery walls. These blockages restrictblood circulation, mainly in arteries leading to

the kidneys, stomach, arms, legs and feet.

People with PAD often have fatty buildups inthe arteries of the heart and brain, but PADmay be their first sign. Most people with PADhave a higher risk of death from stroke andheart attack. If a blood clot forms and blocksa narrowed artery to the heart, a heart attackresults. If the clot blocks an artery to thebrain, a stroke results.

Is peripheral artery disease dangerous?

Peripheral vascular disease (PVD) refers todiseases of blood vessels outside the heartand brain. It's often a narrowing of vesselsthat carry blood to the legs, arms, stomachor kidneys.

There are two types of these circulation disorders:

• Functional peripheral vascular diseasesdon't have an organic cause. That meansthey don't involve defects in blood vessels'structure. (The blood vessels aren’tphysically damaged in some way.) Thesediseases often have symptoms related to“spasm” that may come and go.Raynaud's disease is an example. InRaynaud’s disease, restricted circulationcan be triggered by cold temperatures,emotional stress, working with vibratingmachinery or smoking.

• Organic peripheral vascular diseases arecaused by structural changes in the blood

vessels. Examples could includeinflammation and tissue damage.Peripheral artery disease (PAD) is a type oforganic PVD. It's caused by fatty buildups(atherosclerosis) in the inner walls ofarteries that block normal blood flow.

In its early stages, common symptoms ofpoor leg circulation are cramping, fatigue,heaviness, pain or discomfort in the legs andbuttocks during activity. This usually subsideswhen the activity stops. It’s called“intermittent claudication.”

Symptoms of poor kidney circulation includesudden high blood pressure, or bloodpressure that is hard or impossible to controlwith medications. Severe blockage of thekidney arteries may result in loss of kidneyfunction or failure.

What are the symptoms?

Normal Blood Vessel

TunicaAdventitia

Tunica Media(smooth muscle)

Vessel Lumen

▲

▲

Tunica Intima

Atherosclerosis

Fibrous Cap

Lipid Core

Decreased VesselLumen

▲

▲

Diagnosing PAD begins with a medicalhistory and physical exam. In the exam, yourdoctor can do a simple test called the ABI(ankle brachial index). After that, other testsmay be done. They include:

• duplex ultrasound• magnetic resonance angiogram• CT angiogram• regular (catheter-based) angiogram

How is PAD diagnosed?

Most people with PAD can be treated withlifestyle changes, medicines or both. Lifestylechanges to lower your risk include:

• stop smoking (smokers are 2 to 25 timesmore likely to get PAD)

• control diabetes

• control blood pressure

• be physically active (including a supervisedexercise program)

• eat a low-saturated-fat, low-cholesterol diet

PAD may require drug treatment, including:

• medicines to help improve walking distance(cilostazol and pentoxifylline)

• antiplatelet agents to keep the plateletsfrom sticking together and triggering ablood clot

• cholesterol-lowering agents (statins)

Lifestyle modifications (including an exercise

program) usually improve symptoms or keepthem from getting worse. In a minority ofpatients, lifestyle changes alone aren’t sufficient.Then angioplasty or surgery may be needed.

Angioplasty is a non-surgical procedure thatwidens narrowed or blocked arteries. A thintube called a catheter with a deflated balloonon its tip is passed into the narrowed arterysegment. Then the balloon is inflated. Thispushes open the narrowed segment. Then theballoon is deflated and the catheter is withdrawn.

Often a stent — a wire mesh tube — is placedin the narrowed artery with a catheter. There thestent expands and locks open. It stays in thatspot, keeping the diseased artery open.

If a long part of an artery is narrowed, surgerymay be needed. A vein from another part ofthe body or a synthetic blood vessel isattached above and below the blocked areato detour blood around the blocked spot.

How is PAD treated?

What is Peripheral Vascular Disease? (continued)

How can I learn more?1. Talk to your doctor, nurse or other health-

care professionals. If you have heartdisease or have had a stroke, members ofyour family may be at higher risk. They needto make changes now to lower their risk.

2. Call 1-800-AHA-USA1 (1-800-242-8721) or visit americanheart.org.

3. For information on stroke, call 1-888-4-STROKE (1-888-478-7653) or visit usonline at StrokeAssociation.org.

We have many other fact sheets andeducational booklets to help you.

Knowledge is power, so Learn and Live!

Should I be checked for PVD?

• Take a few minutes to write your own questions for the next time you see your healthcare provider. For example:

Do you have questions or comments for your doctor or nurse?

©1994, 2002, 2004, American Heart Association.

The statistics in this sheet were up to date at publication. For the latest statistics,see the Heart Disease and Stroke Statistics Update at americanheart.org/statistics.