Peripheral artery disease is a vascular system disorder characterized primarily by the obstruction of limb arteries due to fatty deposits, leading to inadequate blood supply. This condition most commonly affects the lower limbs and may cause walking pain or tissue necrosis, with severe cases potentially requiring amputation. Early diagnosis and treatment are crucial for improving quality of life.
According to epidemiological studies, the incidence rate in populations over 60 years old can be as high as 20%. However, early symptoms are often overlooked and mistaken for age-related degeneration. Modern medicine has developed various diagnostic techniques and treatment options, and patients who cooperate with medical advice can effectively slow disease progression.
The core cause of the disease is atherosclerosis, where cholesterol deposits gradually narrow the arterial intima. Multiple factors exacerbate this pathological change:
Main risk factors include:
The typical symptom is "intermittent claudication," where patients experience calf muscle cramping after walking about 200 steps, relieved by rest. Atypical symptoms include:
Severe cases may develop "rest pain," where patients feel deep foot pain even at rest. About 15% of patients may experience tissue necrosis, with foot ulcers extending to the bones, leading to chronic osteomyelitis.
Initial screening often uses the ankle-brachial index (ABI), where an ankle blood pressure to arm blood pressure ratio below 0.9 is abnormal. Imaging examinations include:
If complications are suspected, tissue biopsy may be performed. The diagnostic process generally includes:
Smoking cessation programs should combine medication and behavioral therapy. Nicotine replacement therapy combined with counseling can improve success rates. Daily walking training is recommended, starting from 15 minutes and gradually extending to 45 minutes to promote collateral circulation formation.
Antiplatelet drugs such as aspirin or clopidogrel can reduce thrombosis risk. Lipid-lowering therapy mainly involves statins, with LDL cholesterol targets below 1.8 mmol/L. Vasodilators like cilostazol can improve walking tolerance.
Angioplasty uses balloon dilation of stenotic areas, and stent placement can maintain vessel patency. Severe blockages may require bypass surgery, reconstructing blood flow routes using autologous veins or synthetic grafts. Emerging treatments such as extracorporeal shock wave therapy are currently in clinical trials.
The primary prevention strategies include:
Secondary prevention involves ongoing monitoring of atherosclerosis indicators, including high-sensitivity C-reactive protein and lipoprotein(a). It is recommended to perform ankle-brachial index screening every six months, with quarterly follow-up for high-risk groups on lipid and blood sugar levels.
Seek immediate medical attention if you experience:
Mild symptoms such as slight pain when walking should also prompt a consultation within two weeks. An annual foot artery ultrasound can detect vascular stenosis exceeding 50% early.
Pain caused by peripheral artery disease typically occurs during walking or activity, relieved by rest, and often accompanies coldness or weakness in the lower limbs. Unlike muscle fatigue, this pain may be associated with weakened or absent pedal pulses or pallor of the skin, and should be confirmed with ankle-brachial index (ABI) testing or arterial ultrasound.
Are symptoms more likely to worsen in winter?Yes. Cold temperatures cause vasoconstriction, reducing blood flow to the limbs, which may worsen intermittent claudication or limb coldness. Patients are advised to keep warm, wear appropriate clothing, and use vasodilator medications as prescribed to improve blood flow.
After angioplasty or stent placement, is lifelong anticoagulant therapy necessary?The need for long-term antiplatelet therapy (such as aspirin) depends on the severity of the condition and risk of complications. Most patients require ongoing medication to prevent thrombosis, but the specific plan should be determined by a physician based on lipid, blood sugar, and other indicators.
What are the key nursing considerations for diabetic patients with peripheral artery disease?Diabetic patients with peripheral artery disease should strictly control blood sugar, blood pressure, and cholesterol, as hyperglycemia accelerates vascular hardening. Foot care is especially important, including daily inspection for skin changes to prevent unnoticed ulcers due to nerve damage, which increases the risk of amputation.
What is "rest pain"? Does it indicate the disease has entered a severe stage?"Rest pain" refers to persistent lower limb pain even at rest, usually occurring in the toes, indicating severe tissue ischemia. This symptom may be accompanied by ulcers or tissue necrosis and requires immediate medical evaluation for possible revascularization surgery.
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