What is Peripheral Arterial Disease (PAD)?
Peripheral Arterial Disease (PAD) Explained
What is Peripheral Arterial Disease or PAD?
Peripheral Arterial Disease (PAD), or to be more precise, LEAD (Lower Extremity Artery Disease) is a common circulatory problem in which narrowed arteries reduce the blood flow to your limbs.
When PAD develops, your extremities – usually your legs – don’t receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (intermittent claudication).
Over 70% of patients do not know about the disease because they do not feel or recognise the symptoms until severe complications occur.
PAD is likely to be a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis). This condition may be reducing blood flow to your heart and brain, not only to your legs.
Early diagnosis of PAD in primary healthcare is crucial.
Who is at risk for PAD?
PAD is associated with other cardiovascular complications. Its prevalence increases with age. As the world’s populations grow older, so does the number of PAD patients.
Who should be diagnosed for PAD or LEAD?
70% of patients with PAD experience no symptoms and are not diagnosed. Cardiology associations recommend Ankle-Brachial Index screening on the complete PAD risk group for early detection of the disease.
Everybody in the risk group should be screened for PAD / LEAD.
LEAD risk group
1. Patients with clinical suspicion for LEAD: Unnoticeable pulse in lower extremities and/or arterial bruit. Typical intermittent claudication or symptoms suggestive for LEAD.
Non-healing lower extremity wound.
2. Patients with clinical conditions which may cause a risk for LEAD: Atherosclerotic diseases: CAD, any PADs.
AAA, CKD, heart failure.
3. Asymptomatic individuals at risk for LEAD
Guidelines give a meaning to our work
According to different guidelines, such as ACC/AHA, ABI measurement should be performed on all patients in the risk group.
New 2017 ESC guidelines emphasize ABI measurement even more. ABI measurement is not only a tool for the diagnosis of LEAD, but it is also a strong marker for atherosclerosis and CV risk detection. In addition to the basic risk group for PAD (LEAD), the patients who should have their ABI measured are also those who are at risk for LEAD because of CAD, and PADs, AAA, CKD and heart failure.
The term “masked LEAD” covers the group of patients, who do not develop the usual symptoms, due to their inability to walk for an extended period of time or have their pain masked by neuropathy. These patients are at greater risk for severe PAD.