(PVD; PAD; Arteriosclerosis Obliterans; Atherosclerosis; Peripheral Vascular Arterial Disease)
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- Pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s) brought on by exercise that goes away when resting
- Numbness and pain of the legs or feet at rest
- Cold hands, legs, or feet
- Loss of hair on the legs and/or feet
- Paleness or blueness of the legs
- Weak or absent pulse in the leg
- Sores, ulcer, or infection of the feet and legs that heal slowly
- Erectile dysfunction
- Swelling in lower extremities
- Muscle atrophy
- Check the strength of the pulse in the leg arteries
- Listen for a whooshing sound in a leg artery or the abdomen using a stethoscope
- Check blood pressure at various points in the leg and compare it to the normal arm blood pressure
- Conduct a treadmill test
- Smoking cessation
- Diabetes control
- Blood pressure control
- Increased physical activity —such as a walking program
- Weight loss , if overweight
- Low-saturated fat, low-cholesterol diet
- Foot care
—very important for people with diabetes:
- Shoes that fit properly
- Proper treatment of all foot injuries—healing is slowed when circulation is poor, so the risk of infection is higher
- Blood thinners
- Pain medication
- Cholesterol-lowering agents called statins
- Medicines to enlarge or dilate the affected arteries
- Endarterectomy —the lining of the artery is removed, along with plaque build up
- Bypass surgery—a vein from another part of the body or a synthetic graft replaces the vessel
American Academy of Family Physicians http://familydoctor.org
Vascular Disease Foundation http://www.VDF.org
Canadian Society for Vascular Surgery http://canadianvascular.ca
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca
About peripheral artery disease (PAD). American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/PeripheralArteryDisease/About-Peripheral-Artery-Disease-PAD%5FUCM%5F301301%5FArticle.jsp . Updated September 13, 2012. Accessed May 9, 2013.
American College of Cardiology and American Heart Association 2005 Practice Guidelines for the management of patients with peripheral arterial disease. Circulation . 2006;113:e463-654.
Gey DC, Lesho EP, Manngold J. Management of Peripheral Arterial Disease. Am Fam Physician . 2004;69:525-532.
Lumsden AB, Rice TW. Medical management of peripheral arterial disease: a therapeutic algorithm. J Endovasc Ther . 2006;13(suppl 2)II19-29.
Mahmud E, Cavendish JJ, Salami A. Current treatment of peripheral arterial disease: role of percutaneous interventional therapies. J Am Coll Cardiol . 2007;50:473-490.
Peripheral arterial disease. Am Fam Physician . 2004 Feb 1;69(3):533. Available at: http://www.aafp.org/afp/2004/0201/p533.html . Accessed May 9, 2013.
Peripheral arterial disease and claudication. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/peripheral-arterial-disease-and-claudication.html . Updated January 2011. Accessed May 9, 2013.
Regensteiner JG, Stewart KJ. Established and evolving medical therapies for claudication in patients with peripheral arterial disease. Nat Clin Pract Cardiovasc Med . 2006;3: 604-610.
What is peripheral artery disease (PAD)? Vascular Disease Foundation website. Available at: http://www.vdf.org/diseaseinfo/pad/ . Updated May 11, 2012. Accessed May 9, 2013.
11/18/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com : Rooke TW, Hirsch AT, Misra S, et al. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation . 2011;124(18):2020-2045.