Are there possible prevention of PAD? Yes , it's the same key recommendation of the health authorities.
Keep a correct lifestyle all his life almost completely reduced the risk of peripheral arterial disease to an advanced age. That is to say , remove or correct cardiovascular risk factors such as smoking , high cholesterol , obesity , hypertension or diabetes.
Tobacco mouth especially large vessels and this arteritis is at greater risk of myocardial infarction and stroke. Diabetes , especially if it is unbalanced , particularly small mouth vessels , promotes severe arteritis feet and legs , leading to amputations.
Walking daily (30 minutes , 1 hour or more) slows the worsening of the disease and rejuvenates the arteries (flow replacement). Must adapt its walking speed so as not to cause pain. And exercising regularly within this pain in an atmosphere polluted as little as possible.
When to call the doctor? Any leg pain that occurs when walking to encourage them to consult a doctor.
Pain cellular asphyxia (ischemia) occurs , depending on the stage of the disease , after a precise distance , which is a few miles or a few hundred meters to a few tens of meters. Doctors speak of walking distance. It establishes the stage of the disease.
Over the perimeter is low , and above all it shortens more urgent it is to consult. In extreme cases the pain occurs at rest sitting , even when longer legs (decreased blood flow) at bedtime. At this stage the total occlusion of the artery is feared quickly , with a high risk of gangrene , amputation so.
More treatment is early , the chances of recovery are important.
Arterial occlusive disease (PAD) - Consultation How to prepare for the consultation? Must prepare all of his medical records (personal and family history , smoking habits , blood pressure numbers) , current medications (prescribed or taken alone in medication).
It is important to measure the walking distance: distance in meters traveled to the apparation pain , and / or number of minutes of effort before it starts.
What is the doctor? After a thorough clinical examination with palpation of especially the leg and foot , it measures the blood pressure in the arm and ankle to determine the systolic pressure index (or IPS). The abolition of the pulse , or an IPS or less 0.90 sign PAD , there are no signs or painful leg effort: many PAD does not cause pain remarkable.
The doctor completes the balance sheet with an echo-doppler (ultrasound examination of the arteries) done by a cardiologist or angiologue. An audit of cardiac and cerebral arteries (among others) is recommended in this report echo-doppler. The cardiologist judge the relevance of additional tests as a CTA.
The gold standard to specify the extent of arterial disease is angiography (X-ray of the artery after opacification). Given its complexity and cost , it is made final when considering an intervention to unblock arteries stenotic (narrowed and / or bites).
The bloodwork particular research diabetes , lipid abnormalities , renal ...
Treatment It depends on the stage of the disease. It begins with drugs:
- Against fat accumulation by arterial cholesterol ,
- Against the formation of blood clots in the arteries narrowed areas by antiplatelet ,
- By dilating arteries with vasodilators whose effectiveness is discussed if they are no longer recommended by the Haute Autorité de Santé (HAS).
Medical treatment always includes a correction of the lifestyle factors and cardiovascular risk: essential stop smoking (first cause of arteritis) , weight loss if needed , exercise daily (supervised or not centrally rehabilitation) , balanced diet ...
In case of failure of this support or when the situation is serious (severe ischemia or acute) , surgical treatment is necessary: arterial dilation , removal of the clot , bypass ...
American scientific societies offer a range of 7 measures (preventive and corrective) of peripheral arterial disease (Olin et al. JACC December 14 , 2010):
- Systematically Ankle Brachial Index (GPI) of patients;
- Prescribe statins (cholesterol lowering drugs)
- Prescribing antiplatelet
- Stop smoking ,
- Prescribing physical surveillance ,
- Monitor vein grafts used to bypass arterial
- Monitor large aortic aneurysms.
