Peripheral artery disease is a vascular system disorder characterized by the obstruction of arteries in the limbs due to fat deposits, leading to insufficient blood supply. This condition primarily affects the lower limbs and can cause pain while walking or tissue necrosis, and in severe cases, may even require amputation. Early diagnosis and treatment are crucial for improving quality of life.
According to epidemiological studies, the incidence of this disease is as high as 20% in individuals over 60 years old, but early symptoms are often overlooked and commonly misidentified as general age-related degenerative issues. Modern medicine has developed various diagnostic techniques and treatment options, and patients who adhere to medical advice can effectively slow the progression of the disease.
The core cause of the disease is atherosclerosis, where the vascular endothelium gradually narrows due to cholesterol deposits. Multiple factors can exacerbate this pathological change:
The main risk factors include:
The typical symptom is "intermittent claudication," where patients experience cramping pain in the calf muscles after walking about 200 steps, which alleviates after resting. Atypical symptoms include:
In severe cases, "rest pain" may occur, where patients feel deep pain in the soles of their feet even at rest. About 15% of patients may experience tissue necrosis, and foot ulcers may extend to the bones, leading to chronic osteomyelitis.
Initial screening often uses the Ankle-Brachial Index (ABI), where a ratio of ankle blood pressure to arm blood pressure below 0.9 is considered abnormal. Imaging examinations include:
If complications are suspected, the physician may conduct a tissue biopsy. The diagnostic process typically includes:
Smoking cessation programs should combine medication and behavioral therapy, with nicotine replacement therapy and behavioral counseling improving success rates. Daily walking training is recommended, starting from 15 minutes and gradually extending to 45 minutes to promote collateral circulation formation.
Antiplatelet medications such as aspirin or clopidogrel can reduce the risk of thrombosis. Lipid-lowering treatment primarily uses statins, with an LDL cholesterol target value below 1.8 mmol/L. Vasodilators such as cilostazol can improve walking tolerance.
Angioplasty uses balloon dilation at the narrowed site, and stent placement can maintain vascular patency. Severe blockages may require bypass surgery, using autologous veins or synthetic grafts to reconstruct blood flow pathways. Emerging treatments such as extracorporeal shock wave therapy are in clinical trial stages.
Primary prevention strategies include:
Secondary prevention requires continuous monitoring of atherosclerosis indicators, including high-sensitivity C-reactive protein and lipoprotein(a). It is recommended to conduct ABI screening every six months, and high-risk groups should track blood lipids and blood sugar quarterly.
If the following conditions occur, seek medical attention immediately:
Mild symptoms such as slight soreness while walking are also recommended to be evaluated within two weeks after they appear. Annual foot artery ultrasound examinations can help detect vascular stenosis exceeding 50% early.
Pain caused by peripheral artery disease typically occurs during walking or activity and alleviates after resting, often accompanied by coldness and weakness in the lower limbs. Unlike muscle fatigue, this pain may be associated with diminished capillary pulsation in the feet or pale skin, and it is advisable to confirm through Ankle-Brachial Index (ABI) testing or arterial ultrasound.
Are patients more likely to experience exacerbated symptoms in winter?Yes. Low temperatures can promote vasoconstriction, reducing blood flow to the limbs, which may worsen symptoms of intermittent claudication or coldness in the limbs. Patients are advised to keep warm indoors during winter, wear warm clothing, and use vasodilator medications as prescribed to improve blood flow.
After angioplasty or stent placement, is lifelong anticoagulation necessary?Whether long-term use of antiplatelet medications (such as aspirin) is required after surgery depends on the severity of the condition and the risk of complications. Most patients need to continue taking them to prevent thrombosis, but specific regimens should be determined by the physician based on blood lipid, blood sugar, and other indicators.
What are the nursing priorities for diabetic patients with peripheral artery disease?Patients with diabetes and peripheral artery disease need to strictly control blood sugar, blood pressure, and cholesterol, as high blood sugar can exacerbate vascular hardening. Foot care is especially important; daily skin checks are necessary to avoid neglecting ulcers due to lack of pain sensation from nerve damage, which increases the risk of amputation.
What is "rest pain"? Does this indicate that the disease has reached a severe stage?"Rest pain" refers to persistent pain in the lower limbs even at rest, usually occurring in the extremities such as the toes, indicating that tissue ischemia has reached a severe stage. This symptom may be accompanied by limb ulcers or tissue necrosis, requiring immediate medical evaluation to assess the necessity of blood flow reconstruction surgery.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
