Peripheral Arterial Disease (PAD) is a type of vascular disease that affects the arteries. Also known as leg attack, it is a condition in which plaque builds up in the arteries that carry blood to the head, organs, and limbs. PAD is a common disorder but since it is not always life-threatening, it has not received the same degree of attention or research as coronary heart disease. PAD may be a precursor of coronary heart disease since people with narrowed peripheral arteries are also more likely to have a narrowing of the coronary arteries which can be fatal.
There are certain complications around PAD. In some rare cases, blood clots can develop suddenly in a major artery in the leg – a condition also known as acute occlusion. Symptoms for the same include numbness, pain, coolness, pale colour, lack of pulse in the artery, and weakness. This can lead to amputation or even loss of life. Treatment options include Drug Coated Balloons (DCB) which helps in keeping the vessels clear, without leaving metal behind in the body.
Approximately 15% of all patients who suffer from diabetics are at risk of PAD. India has an estimated 65.1 million diabetics. Conservative estimates put approximately 10 million patients at risk. 40,000 legs are amputated in India each year. With early detection and management about 85% of these legs can be salvaged.
Smokers also are at a high risk of PAD. In fact smokers have a significantly greater risk of developing PAD than people who have never smoked. The inhalation of cigarette smoke results in the rapid absorption of nicotine, with a consequent release of adrenaline and noradrenaline (neurotransmitters). These bind to receptors within the muscular wall of vessels to cause vasoconstriction (narrowing of the blood vessels from contraction of the muscular wall of the vessel).
Dr. Vimal Someshwar, Director Interventional Radiologist at Kokilaben Dhirubhai Ambani Hospital, Mumbai says, “There are numerous risk factors for PAD. Some are due to underlying medical conditions, age, and gender while others are due to lifestyle choices. Smoking and Diabetes are one of the major causes of PAD. Other risk factors that lead to PAD are abnormal lipids (high cholesterol), high blood pressure, obesity etc. The prevalence of PAD in the lower limbs in a general population is more in 55 years of age is between 10% and 25% and it increases with age. People who have PAD are also at increased risk for heart diseases and strokes.”
“It is now also possible to open up entirely blocked arteries that were previously not seen on the angiography. Balloon angioplasty and stenting have generally replaced invasive surgery as the first-line treatment for Peripheral Vascular Disease where an interventional radiologist inflates a balloon to open the blood vessel narrowed or blocked, and in some cases this is then held open with a stent. Advances in technology make it possible to restore circulation in big and small arteries even as far as the foot using thin wires, thin catheters (micro-catheters) and Drug coated balloons opening an entire new horizon for treating those cases that had to have open surgery with long bypass operations that took 6-8 hours in the past.” he further added.
The best way to prevent PAD is to control diabetes, stop smoking, healthy diet, regular exercise, correct medications for high cholesterol and control blood pressure. Quitting smoking is one of the most important ways to treat PAD as it directly causes reduced blood flow in vessels. An often active treatment for PAD symptoms is regular physical activity. Doctors may recommend a program of supervised exercise training for you, also known as cardiac restoration. Simple walking regimens, leg exercises and treadmill exercise programs can ease symptoms.