Peripheral Artery Disease (or Peripheral Vascular Disease or Peripheral Occlusive Disease) is the narrowing or blockage (stenosis) of the arteries of the leg, most commonly caused by atherosclerosis (hardening of the arteries).
The arteries of the legs initiate at the pelvis where the aorta, the largest artery of our body, bifurcates to two large blood vessels, the right and left iliac arteries.
Each iliac artery runs through the pelvis to the groin where it transitions to the femoral artery.
The femoral artery runs through the thigh down to the knee where it transitions to the popliteal artery and the popliteal artery trifurcates below the knee to three small arteries, the anterior tibial artery, the posterior tibial artery and the peroneal artery.
These three arteries direct blood flow to the foot.
All these arteries comprise the so-called "circulation" of the leg and supply oxygenated blood and nutrients to the limb enabling our walking capacity as well as our ability to heal any wounds.
The more intense our activity is the higher the demand for blood flow.
A good leg circulation means that all these arteries are widely open (patent), allowing us to perform our activities uninterrupted.
Peripheral Artery Disease progression can lead to severe narrowing of the arterial lumen in one or more of the arteries of the leg.
The blood supply to the limb can be then decreased to such a level that is inefficient to support walking or even wound healing.
Peripheral Artery Disease can manifest as leg pain, delayed wound healing and at the very advanced stages can lead to gangrene and need for a minor or major amputation.
Atherosclerosis is the most important risk factor for the development of Peripheral Artery Disease.
Atherosclerosis is the buildup of cholesterol, fat, calcium and other waste products that travel through the bloodstream and deposit on the inner surface of the arteries to form the so-called atherosclerotic plaque.
This is usually the result of smoking, high blood pressure (hypertension), high cholesterol (hypercholesterolemia), diabetes and/or aging (>60 years old).
Although these risk factors increase a person's risk, they do not necessarily cause the disease.
Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors, indicating the effect of the genes (family history).
Patients with Peripheral Artery Disease will frequently have Coronary Heart Disease and Carotid Artery Disease as all these three conditions share the same risk factors.
Non-atherosclerotic forms of Peripheral Arterial Disease include Buerger's disease and Raynaud's disease or phenomenon.