PAD is a common circulation problem in which the arteries that
carry blood to the legs or arms become narrowed or clogged. This
interferes with the normal flow of blood, sometimes causing pain,
but often causing no symptoms at all. The most common cause of PAD
is atherosclerosis, often called "hardening of the arteries."
Atherosclerosis is a gradual process in which cholesterol and scar
tissue build up, forming a substance called "plaque" that clogs the
blood vessels. In some cases, PAD may be caused by blood clots that
lodge in the arteries and restrict blood flow. Left untreated, this
insufficient blood flow will lead to limb amputation in some
In atherosclerosis, the blood flow channel narrows from the
buildup of plaque, preventing blood from passing through as needed,
restricting oxygen and other nutrients from getting to normal
tissue. The arteries also become rigid and less elastic, and are
less able to react to tissue demands for changes in blood flow.
Many of the risk factors-high cholesterol, high blood pressure,
smoking and diabetes-may also damage the blood vessel wall, making
the blood vessel prone to diffuse plaque deposits.
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Many people simply live with their pain, assuming it is a normal
part of aging, rather than reporting it to their doctor.
Often PAD can be treated with lifestyle changes. Smoking cessation
and a structured exercise program are often all that is needed to
alleviate symptoms and prevent further progression of the
Angioplasty and stenting
Interventional radiologists pioneered angioplasty and stenting,
which was first performed to treat peripheral arterial disease.
Using imaging for guidance, the interventional radiologist threads
a catheter through the femoral artery in the groin to the blocked
artery in the legs. Then he or she inflates a balloon to open the
blood vessel where it is narrowed or blocked. In some cases this is
then held open with a stent, a tiny metal cylinder. This is a
minimally invasive treatment that does not require surgery, just a
nick in the skin the size of a pencil tip.
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