Peripheral Arterial Occlusive Disease (PAD) Claudication
Claudication - the term comes from the fact that those affected can only walk short distances before they have to stop and take a break, just like window shopping. However, it is a serious condition medically known as peripheral arterial occlusive disease (PAD). PAD is also known as "smoker's leg."
It refers to the progressive narrowing of the arteries that supply the extremities. In the legs, this involves atherosclerotic changes in the pelvic or leg arteries, leading to a decreasing blood flow to the legs. The tissue is no longer adequately supplied with oxygen and nutrients, which can cause pain. As a result, the symptoms described above occur. In the worst case, the tissue dies, and amputation may be necessary.
- About 50 percent of PAD cases are found in the femoral artery. The pulse in the popliteal fossa and at the foot is no longer palpable. Pain occurs mainly in the calf area.
- In about 30 percent of cases, the narrowing is localized in the pelvic arteries. The pulse is also not palpable in the groin. Pain can also occur in the buttocks and thigh. If the narrowing is slightly higher - namely in the abdominal aorta before the bifurcation of the pelvic arteries - it is referred to as Leriche syndrome. Here, too, the legs are no longer adequately perfused. Additionally, there may be disturbances of the bladder and rectum, and in men, erectile problems up to impotence may occur.
- 20 percent of PAD cases occur in the arteries of the lower legs. In this case, the pulse at the foot is no longer palpable, and the pain affects the sole of the foot.
- Less frequently, the arteries of the arms are affected by PAD.
Therefore, the presence of PAD is also considered a risk factor for other diseases such as heart attack, stroke, or sudden cardiac death.
The development of PAD often goes unnoticed at first. Symptoms only occur after a certain degree of narrowing.
Peripheral arterial occlusive disease can therefore be classified into different stages:
How is PAD detected?
When a doctor suspects PAD, the ABI value is determined. For this, he measures the blood pressure at the arm and above the ankle using a cuff and an ultrasound Doppler probe. The systolic value at the ankle is then divided by the systolic value at the upper arm. If the vessels are healthy, the value is approximately equal, and the ABI value is about 1.0. PAD is present if the value is 0.9 or less. This is further clarified through an ultrasound examination. If that is not sufficient or if surgery is pending, further investigation can be done using MRI, angiography, or catheterization.
What to do?
Even with PAD, changing one's lifestyle is essential to slow the progression of the disease. Walking is particularly important in this case, as walking training is vascular training.
Additionally, medication therapy may be necessary. In severe cases, the option of dilation with a catheter or the placement of a stent as an invasive therapy is available. In a vascular operation, the vessel can be reopened or a bypass can be created.
Of course, the best thing is to prevent it from getting to that point at all and to prevent the onset or progression of the disease through a healthy lifestyle and exercise.
Sources:
By Sabine Croci.
This article is medically reviewed. Last updated (01/2024).
Information on the website and within the app cannot replace a consultation with a doctor, but can certainly complement it.
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