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Alternative Names Return to topPeripheral vascular disease; PVD; Peripheral arterial disease; PAD; Arteriosclerosis obliterans
Definition Return to top
Arteriosclerosis of the extremities is a disease of the blood vessels that leads to narrowing and hardening of the arteries that supply the legs and feet. This decreases blood flow, which can injure nerves and other tissues.
Causes Return to top
Arteriosclerosis, or "hardening of the arteries," commonly first affects the legs and feet. The narrowing of the arteries may lead to a total closing (occlusion) of the vessel.
The vessel walls become less elastic and cannot open (dilate) to allow greater blood flow when needed (such as during exercise). Calcium deposits in the walls of the arteries contribute to the narrowing and stiffness.
This is a common disorder, usually affecting men over age 50. People are at higher risk if they have a personal or family history of:
Symptoms Return to top
Often, symptoms affect one limb. If arteriosclerosis is in both limbs, the intensity is usually different in each.
Exams and Tests Return to top
During an examination, the health care provider may find:
Blood tests may show high cholesterol.
Tests for peripheral artery disease:
Treatment Return to top
Treatment focuses on relieving symptoms and improving circulation.
Medications may be required to control the disorder, including:
Surgery is usually performed only in severe cases if the condition is affecting your ability to work or pursue essential activities. Surgery may involve:
Some people with peripheral artery disease may need to have the limb removed (amputated). Rates of amputation are particularly high among African Americans and Hispanics with diabetes.
Alternatives to surgery may include balloon angioplasty (a similar technique to that used to open the coronary arteries, but performed on the blood vessels of the affected extremity). This may be followed by stent implantation, laser treatment, or other treatments.
Outlook (Prognosis) Return to top
You can usually control arteriosclerosis of the extremities with treatment. Surgery provides good symptom relief. Complications may require amputation of the affected leg or foot.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you have symptoms of arteriosclerosis of the extremities.
Call your health care provider if you develop new symptoms, especially:
Prevention Return to top
Control risk factors such as:
References Return to top
Creager MA, Libby P. Peripheral Arterial Disease. In: Libby P, Bonow RO, Mann DL, Zipes DP. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders; 2007:chap 57.
Aung PP, Maxwell HG, Jepson RG, Price JF, Leng GC. Lipid-lowering for peripheral arterial disease of the lower limb. Cochrane Database Syst Rev. 2007;Oct 17(4):CD000123.Update Date: 5/15/2008 Updated by: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.