Peripheral artery disease
What is peripheral artery disease?
Peripheral artery disease (PAD) – also known as peripheral vascular disease (PVD) – is a narrowing of the arteries that causes reduced blood flow in an area of the body other than the heart or brain.
PAD often occurs in the legs, and less frequently in the arms.
What are the symptoms of peripheral artery disease?
Symptoms of PAD will depend on the severity of the condition and which body parts are affected.
Symptoms may include:
- muscle pain, cramping, or heaviness
- numbness or pins and needles
- coldness in the affected body part
- sores on the legs, feet and toes that don’t heal
- changes to the skin, such as shiny or dry skin and colour changes
- blackened areas of skin/tissue (known as gangrene)
- a weak pulse in the legs or feet
- reduced lower limb hair/nail growth
What causes peripheral artery disease?
A large majority of PAD is caused by atherosclerosis, which is a buildup of plaque in the arteries that leads to narrowing or blockages.
Factors that can contribute to atherosclerosis risk include:
- diabetes
- high cholesterol
- high blood pressure
- smoking
- lack of exercise
- obesity
- increased age
PAD may also be caused by:
- a blood clot
- infection
- blood vessel defects or spasms
- inflammation of the arteries
Those with a family history of PAD, heart disease and stroke are also at increased risk of developing PAD.
How is peripheral artery disease diagnosed?
Your doctor will start by discussing your symptoms and medical history, including any family history of PAD, heart disease and stroke.
If they suspect PAD, they will run tests which may include:
- ankle brachial index (ABI) test - to compare the blood pressure in your arms to the blood pressure in your legs
- a pulse check in your legs
- ultrasound or MRI - to check blood vessels for narrowing
- an angiogram - where a contrast agent is injected into the blood vessels to assess blood flow and visualise vessel narrowing
- blood tests for high cholesterol and diabetic markers (HbA1c)
How is peripheral artery disease treated?
Treatment for PAD may include:
- lifestyle changes eg. quitting smoking, walking, eating healthy foods etc.
- medication eg. antihypertensive drugs to lower blood pressure, statins to lower cholesterol, anticoagulants to prevent blood clots and metformin to manage diabetes etc.
- surgery eg. angioplasty and a stent to widen arteries and improve blood flow, or bypass surgery to create a path around the affected artery in severe cases
How can peripheral artery disease be prevented?
If you have diabetes, high blood pressure or high cholesterol, managing these conditions will help to reduce your risk of PAD.
Other lifestyle changes that can reduce the risk of PAD include:
- quitting smoking
- making healthy food choices
- exercising regularly
- maintaining a healthy weight
What research is the Institute conducting into peripheral artery disease?
Dr Renjing Liu and her team in the Institute’s Vascular Epigenetics Laboratory have identified a gene that controls how blood vessels form.
As we age this gene can mutate or diminish, which can affect the growth and regeneration of blood vessels. More importantly, the loss of this gene has been strongly linked to the occurrence of PAD, along with poor recovery in people with PAD.
The Liu Laboratory is currently examining ways to modulate the expression and activity of this gene to test whether it’s possible to coax the regeneration of damaged arteries or grow new vessels in those with PAD.
This research may have implications for blood vessel regeneration in other areas of the body, including the heart and the brain. It could potentially provide another risk factor to screen for through blood tests, potentially identifying PAD earlier and increasing the likelihood of preventing PAD.
Unfortunately, many patients with severe PAD face amputation. Tragically these patients often pass away within a year following the procedure. The Liu Laboratory is aiming to prevent amputations by encouraging blood vessel growth to the blocked areas, a strategy not currently used in conventional PAD management.
Dr Liu’s research is made possible through the use of the micro-computed tomography scanner and magnetic resonance imaging at the Institute’s Innovation Centre.
Acknowledgement of Country
The Victor Chang Cardiac Research Institute acknowledges Traditional Owners of Country throughout Australia and recognises the continuing connection to lands, waters and communities. We pay our respect to Aboriginal and Torres Strait Islander cultures; and to Elders past and present.
