Peripheral artery disease (PAD) is the narrowing or blockage of arteries outside the heart and brain due to atherosclerosis. This disease, which most commonly affects leg arteries, can lead to serious consequences from walking difficulty to gangrene.
What is Peripheral Artery Disease?#
Peripheral artery disease is the narrowing or blockage of arteries supplying the extremities (especially legs) due to atherosclerosis. It shares the same risk factors as coronary artery disease and is often seen together.
PAD affects more than 200 million people worldwide. It is seen in approximately 20% of the population over 65 years of age.
Symptoms of Peripheral Artery Disease#
Classic Symptoms#
Intermittent Claudication:
- Pain, cramping, or fatigue in legs while walking
- Resolves with rest
- Occurs after a certain distance
- Most common in calf muscles
Critical Limb Ischemia:
- Rest pain (especially at night)
- Coldness and color change in feet
- Non-healing wounds
- Risk of gangrene
Fontaine Classification#
| Stage | Symptom |
|---|---|
| I | Asymptomatic |
| IIa | Mild claudication (>200 m) |
| IIb | Moderate-severe claudication (<200 m) |
| III | Rest pain |
| IV | Ulcer or gangrene |
Risk Factors#
Main risk factors for PAD:
- Smoking: Most important risk factor
- Diabetes: Increases risk 2-4 times
- Hypertension
- Hyperlipidemia
- Advanced age
- Chronic kidney disease
- History of coronary artery disease
Diagnostic Methods#
Non-Invasive Tests#
Ankle-Brachial Index (ABI):
- Simple and reliable screening test
- ABI <0.9: PAD diagnosis
- ABI <0.4: Critical ischemia
Doppler Ultrasonography:
- Vessel structure and flow assessment
- Location and degree of narrowing
CT Angiography:
- Detailed anatomical imaging
- For treatment planning
MR Angiography:
- Imaging without contrast material
- Preferred in kidney failure
Invasive Diagnosis#
Peripheral Angiography:
- Gold standard
- Can be done simultaneously with treatment
Our Treatment Approaches#
Medical Treatment#
Basic treatment in all PAD patients:
- Antiplatelet therapy: Aspirin or clopidogrel
- Statin therapy: LDL target <70 mg/dL
- Hypertension control
- Diabetes management
- Smoking cessation: Absolute necessity
- Exercise program: Increases walking distance
Endovascular Treatment#
Minimally invasive interventional treatment options:
Balloon Angioplasty:
- Widening of narrowed vessel with balloon
- Drug-coated balloons (DCB) reduce restenosis rate
Stent Placement:
- Keeps the vessel open
- Drug-eluting stents are preferred
Atherectomy:
- Mechanical removal of plaque
- Effective in calcified lesions
Chronic Total Occlusion Opening:
- Opening of completely blocked vessels
- Requires special techniques
Surgical Treatment#
In cases not suitable for endovascular treatment:
- Bypass surgery
- Endarterectomy
- Amputation (last resort)
Treatment Areas#
Peripheral vascular interventions are performed in different anatomical regions:
Lower Extremity:
- Iliac arteries
- Femoral arteries
- Popliteal artery
- Tibial arteries
- Foot arteries
Renal Arteries:
- Renovascular hypertension
- Ischemic nephropathy
Subclavian Artery:
- Arm ischemia
- Subclavian steal syndrome
Post-Procedure Care#
After peripheral intervention:
In Hospital:
- Access site monitoring
- Pulse check
- Hydration
After Discharge:
- Antiplatelet therapy
- Statin therapy
- Regular exercise
- Risk factor control
- Periodic check-ups
Frequently Asked Questions#
Is blockage in leg arteries dangerous?
Can I walk after peripheral angioplasty?
Can stents be placed in leg arteries?
Is peripheral vascular disease related to heart disease?
Does quitting smoking help treatment?
Appointment and Contact#
If you would like to schedule an appointment for peripheral vascular disease evaluation or treatment:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.
Related Peripheral Vascular Treatments#
Other peripheral vascular treatments related to peripheral vascular disease:
- Carotid Stenosis - Carotid artery stenosis treatment
- Renal Artery Stenosis - Renal artery stenosis treatment
- Lower Extremity Arterial Disease - Leg artery disease
- Abdominal Aortic Aneurysm - Aortic aneurysm treatment
- Atherectomy - Plaque removal procedure