Overview of the peripheral arterial system

Peripheral arterial disease is a very common circulatory disease in which significant narrowing or occlusion of the arteries reduces blood flow to the extremities. In this case, the extremities, most often the legs, do not receive a sufficient amount of blood and symptoms arise in the form of pain or numbness when walking. If adequate treatment is not provided in time, the disease progresses and ischemia or gangrene usually develops. In this case, amputation of the leg is necessary. Up to 500 lower limb amputations per million inhabitants are performed annually due to lack of recognition or delayed treatment of this disease. Peripheral arterial disease is very widespread, as between 12 and 14% of the population suffers from this disease, and for the elderly over 70 years of age, that percentage is around 20%.

This disease is most often unrecognized in its earlier stages, and it is very important to detect the disease in time, before the appearance of complications. This disease is indicated by the appearance of pain in the lower legs that worsens with effort, for example at the beginning of walking. This type of pain is called claudication, and it is caused by reduced blood flow to the legs through arteries narrowed by atherosclerotic plaques. The pain stops or decreases after the activity is stopped. Symptoms that also point to peripheral arterial disease include: coldness of the legs and feet, especially when compared to the other side, discoloration of the legs, loss of hair on the feet or legs, shiny skin on the legs, weak pulse or no pulse, erectile dysfunction.

If the disease is diagnosed at a later stage when ulcers or even gangrenous changes can appear on the skin, the therapy is often more complex, and the most unfavorable outcome of these changes is amputation of the limb. Smokers, diabetics, people with elevated cholesterol and those with elevated arterial pressure have a higher risk of developing peripheral arterial disease.

Our cardiologists are trained for timely diagnosis of this disease and adequate treatment through endovascular (non-surgical) procedures. An excellent diagnostic test for evaluating peripheral circulation function is the index between the pressure on the hand and the pressure at the height of the ankle (ankle-brachial index, AB index). This index reveals early narrowing changes in the arteries, before the appearance of claudication pain, giving an insight into the state of the arterial system and is an important parameter of preventive medicine. The combination of a clinical examination by an experienced cardioangiologist, AB index and Doppler ultrasound of blood vessels provides a wealth of data for deciding on appropriate therapy and the need for further, interventional procedures.