- Abnormal cholesterol
- Diabetes
- Coronary Artery Disease
- Hypertension
- Renal disease involving hemodialysis
- Smoking
- Stroke
Assessment:
- A whooshing sound with the stethoscope over the artery (arterial bruits)
- Decreased blood pressure in the affected limb
- Loss of hair on the legs or feet
- Weak or absent pulses in the limb
When PAD is more severe, findings may include:
- Calf muscles that shrink (wither)
- Hair loss over the toes and feet
- Painful, non-bleeding ulcers on the feet or toes that are slow to heal
- Cyanosis in the toes or foot
- Thick toenails
Tests for peripheral artery disease:
- Angiography of the arteries in the legs
- Doppler ultrasound exam of an extremity
- Magnetic resonance angiography or CT angiography
Treatment:
- Aspirin or a medicine called clopidogrel (Plavix), which keeps your blood from forming clots in your arteries.
- Cilostazol, a medication to enlarge (dilate) the affected artery or arteries for moderate-to-severe cases that are not candidates for surgery
- Angioplasty and stent placement of the peripheral arteries (this is similar to the technique used to open the coronary arteries, but it is performed on the blood vessels of the affected leg)
- Peripheral artery bypass surgery of the leg
References
Aung PP, Maxwell HG, Jepson RG, Price JF, Leng GC. Lipid-lowering for peripheral arterial disease of the lower limb. Cochrane Database Syst Rev. 2007;4:CD000123.
Creager MA, Libby P. Peripheral arterial disease. In: Libby P, Bonow RO, Mann DL, Zipes DP.
Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders; 2007:chap 57.
Sobel M, Verhaeghe R; American College of Chest Physicians. Antithrombotic therapy for peripheral artery occlusive disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:815S-843S.
