Peripheral arterial occlusive disease

Peripheral artery occlusive disease (PAOD) is also known as peripheral vascular disease (PVD) and peripheral artery disease (PAD) and includes all diseases that result from the obstruction of the large peripheral arteries, the arteries carrying blood to the head, internal organs and limbs. Obstruction may be caused by atherosclerosis, the clogging and hardening of the artery walls; stenosis, the narrowing of the artery walls; an embolism, a blockage caused by a blood clot, a piece of tissue, an air bubble, or a foreign object; or the formation of blood clots. It causes either acute or chronic ischaemia which is an inadequate blood flow and a lack of vital oxygen and nutrients to the organs and limbs concerned.

Symptoms include pain, weakness, or cramping in muscles due to decreased blood flow, sores, wounds, or ulcers that heal slowly or not at all and noticeable change in colour (blueness or paleness) or temperature (coolness) when compared to other limbs.  Diminished hair and nail growth in the affected limb and digits may also be experienced.

PAOD is caused by smoking, diabetes mellitus which causes endothelial and smooth muscle cell dysfunction, high cholesterol levels and high blood pressure.  The risk of PAOD also increases if the patient is over the age of fifty, African-American, male, obese, or has a personal history of vascular disease, heart attack, or stroke.

Treating peripheral arterial occlusive disease

Dependent on the severity of the disease, the following steps can be taken: smoking cessation, regular exercise to help open up alternative small vessels and so limitation in walking often improves. Medication with aspirin and the anti-platelet drug, clopidogrel which reduce clot formation and statins which reduce cholesterol levels, can help with disease progression and address the other cardiovascular risks that the patient may have.

Angioplasty, when a thin tube is inserted to open up the arteries, can be performed on solitary lesions in large arteries; plaque excision, in which the fatty debris is scraped off of the inside of the vessel wall; bypass grafting adding a new piece of artery to circumvent a narrowed artery. When gangrene of toes has set in, amputation is often a last resort to stop infected dying tissues from causing septicaemia.  Arterial thrombosis or embolism has a dismal prognosis, but it is occasionally treated successfully by dissolving and breaking up the blood clots using thrombolytic or clot-busting drugs.