Peripheral Arterial Disease

Peripheral Arterial Disease (PAD) is a condition characterised by the narrowing or blockage of the arteries, which hinders blood flow to the tissues, most commonly observed in the lower limbs. The main cause of this blockage is atherosclerosis, which affects around 3% to 10% of the population, and this number increases to 15% to 20% in adults over the age of 70. The disease is an important marker of cardiovascular risk and is associated with a significant increase in the chances of myocardial infarction and stroke (CVA).

The main risk factors for the development of PAD include the lack of regular physical exercise, high blood pressure, high cholesterol, a family history of heart disease, myocardial infarction, stroke, and abdominal aortic aneurysm. People with diabetes, obesity, and smoking are also more likely to develop the disease due to the impact these conditions have on the health of the blood vessels.

The most common symptom of peripheral arterial disease is leg pain during walking, known as intermittent claudication. The pain occurs because, while walking, the legs demand more oxygen and nutrients, but the blocked arteries cannot supply them adequately. Other signs include numbness or weakness in the legs, colder and paler feet, wounds that do not heal, and pain in the extremities, especially at rest. As the disease progresses, the pain appears after shorter distances, and in the most severe cases, erectile dysfunction may occur.

Diagnosis is often delayed because many patients do not show symptoms until the disease is more advanced. A clinical examination is essential and may reveal signs such as pale skin, absence of hair on the legs, and wounds. To confirm the diagnosis and determine the severity of the disease, imaging tests such as Doppler ultrasound, angiotomography, magnetic resonance angiography, or arteriography are performed.

The treatment of PAD depends on the severity of the blockage and the patient's overall health. The first line of treatment involves lifestyle changes, such as quitting smoking, controlling diabetes and hypertension, losing weight, reducing cholesterol, and engaging in physical exercise. Although exercise does not unblock the arteries, it can help create new pathways for blood to flow. Additionally, there is medication available to improve circulation.

When the blockage is severe, surgery may be necessary to restore blood flow, using techniques such as bypass or balloon catheterisation.