peripheral artery disease

If the arteries to the legs are like supply roads bringing fuel to a city, peripheral artery disease is those roads narrowing with traffic jams of fatty buildup. Atherosclerotic plaque accumulates in the arteries of the limbs, usually the legs, restricting blood flow so that the muscles cannot get enough oxygen when they work hard.

The hallmark symptom is intermittent claudication: a cramping ache in the calf, thigh, or buttock that comes on with walking and eases with rest, because exercising muscle outstrips its restricted blood supply. In more advanced disease, pain may occur even at rest, and poor flow can lead to non-healing wounds or, at the extreme, tissue loss. Many people, however, have no symptoms at all.

A simple bedside test, the ankle-brachial index, compares blood pressure at the ankle with that at the arm to gauge how restricted leg flow is. Importantly, peripheral artery disease is a marker of widespread atherosclerosis, so people who have it also carry a higher risk of heart attack and stroke. Management combines risk-factor control, supervised exercise, antiplatelet and lipid-lowering drugs, and, when needed, procedures to restore flow.