Much like the coronary arteries, the peripheral arteries can be blocked by plaque.
What causes arterial blockage?
Peripheral Vascular Disease (PVD) can result from a condition known as atherosclerosis, where a waxy substance forms inside of the arteries. This substance is called plaque.
When enough plaque builds up on the inside of an artery, the artery becomes clogged, and blood flow is slowed or stopped. This slowed blood flow may cause “ischemia,” which means that your body’s cells are not getting enough oxygen. Clogged peripheral arteries in the lower part of the body (also referred to as peripheral artery disease or PAD) most often cause pain and cramping in the legs.
The risk factors for atherosclerosis in the peripheral arteries are the same as those for atherosclerosis in the coronary arteries. Smoking, diabetes, high blood pressure, and high cholesterol are believed to lead to the development of plaque.
What are the symptoms and signs?
Patients may feel pain in their calves, thighs, or buttocks, depending on where the blockage is. Usually, the amount of pain you feel is a sign of how severe the blockage is. In serious cases, your toes may turn a bluish color, your feet may be cold, and the pulse in your legs may be weak. In severe cases, the tissue dies (this is called gangrene) and amputation may be needed.
Sometimes leg cramps develop when a person walks, and the leg pain usually gets worse with increased activity. This cramping is called intermittent claudication. Like the chest pain of angina, the leg pain of intermittent claudication usually goes away with rest. Cold temperatures and some medicines may also cause leg pain.
How is an arterial blockage diagnosed?
Doctors can make a diagnosis by listening to you describe your symptoms and by checking for a weak pulse in the arteries in your feet. Further tests may include
- Ultrasound, which is a test that uses sound waves to produce an image of blood flow through your arteries.
- Arteriography, which is a test that may be performed if your doctor thinks your condition is serious enough for a percutaneous intervention or surgery. The test uses a harmless dye that is injected into the arteries. It lets doctors see where and how serious the blockage is.
How is a blockage treated?
When the blockages are not severe, this form of PVD can be controlled by losing weight, quitting smoking, and following a regular exercise program that has been approved by your doctor.
A percutaneous intervention (balloon angioplasty or a peripheral stent) may be needed for a severely blocked artery that is causing pain or other symptoms.
Your doctor may also recommend a procedure called a peripheral vascular bypass. This procedure creates a way for blood to flow around one or more of the narrowed vessels. After making an incision in your arm or leg or below your stomach, the surgeon will take an artificial vessel or one of your own veins (called a graft) and connect it to the blocked vessel at points above and below the blockage. This allows blood to flow around, or “bypass,” the blockage.