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Arterial Disease

Blood vessels are tube-like channels running throughout the body. There are two major types of blood vessels. Arteries carry blood away from the heart. Veins carry blood to the heart. Arterial blood provides oxygen and nutrients to the tissues and muscles of the body. The aorta, which comes directly off the heart, is the largest artery of the body. It has many branches that supply blood to all parts of the body.

Arterial disease refers to changes or disorders in the arteries that prevent normal blood flow. The two main types of arterial disease are occlusive disease (narrowing of the artery) and aneurysm disease (enlarging of an artery). A major cause of arterial disease is atherosclerosis.

This is a slow process in which deposits of fat, cholesterol, and calcium build up inside the artery. These deposits are called plaque. Like the inside of a rusty water pipe, the wall of the artery becomes rough, hard, and more narrow. Atherosclerosis mainly affects the main blood vessels of the body, but it occurs to some extent in all arteries. If the aorta, the iliac, femoral, popliteal or tibial arteries become blocked, blood flow to the legs decreases. Arterial disease in the legs, which can be detected early through screening, can be a predictor of coronary and carotid artery disease.

Aneurysms occur when the wall of the artery weakens and swells like a balloon. They are often found in the aorta (the large main artery down the middle of the body) and also occur in the iliac, femoral and popliteal arteries. If an aneurysm is not repaired, rupture of the aneurysm or blockage within the aneurysm may occur. This can be a life and/or limb-threatening condition.

Blood clots may also cause the artery to narrow. Platelets, found in the blood, may attach to the rough surface of the artery, clump together and form a blood clot (thrombus). These blood clots also form in the heart and in aneurysms.

At anytime, a clot can break off and lodge in an artery and obstruct blood flow. This is called an embolus.

Risk Factors
Risk factors are habits, traits or conditions that may increase a person's chance of developing atherosclerosis or aneurysm disease. Risk factors for cardiac and vascular disease that cannot be changed include:

• Family history
• Age
• Gender (male or post-menopausal female)

Risk factors that can be controlled or modified include:

• Cigarette smoking
• High blood pressure
• High blood cholesterol
• Heart disease
• Diabetes
• Blood clotting disorders

Symptoms
When a blockage occurs in an artery to the legs, the following may occur:

• pain in calves, thighs, and/or buttocks during walking(relieved with rest)
• pain at rest (with severe blockage)
• skin discoloration
• coolness of the legs
• loss of hair on toes, feet and legs
• thickening of toenails
• tingling, numbness
• ulcers or gangrene
• impotence in men

A sudden blockage in an artery may cause the following to occur in the leg or legs:

• sudden onset of pain
• paleness or whiteness
• no pulse
• numbness or tingling
• coolness
• paralysis (cannot move)

A blockage in an artery to the kidney may cause:

• high blood pressure
• kidney failure

A blockage in an artery to the intestines may cause:

• abdominal pain after eating
• weight loss
• sudden, severe onset of abdominal pain (with a sudden artery blockage)
• diarrhea

Aneurysms may not produce any symptoms; however, if symptoms are present, they may include:

• abdominal pain
• back pain
• scrotal pain
• pulsating mass in the abdomen
• blue toes

Treatment
Mild to moderate arterial disease may improve with:

• An exercise program
• Control of risk factors
• Angioplasty and /or stenting

For severe disease, arterial bypass surgery may be done to improve blood supply to the legs. A vein from your leg or an artificial graft is used to bypass the blocked artery.

Blockages in the arteries to the kidneys or intestines also may be treated by angioplasty or bypass surgery. Your doctor will talk with you about the options that would be most helpful for you. The best option is often decided after you have had an angiogram (arteriogram) or a magnetic resonance angiogram (MRA). These exams outline blood vessels of the head, neck, arms, legs or other organs. They detect the area and extent of any blockage or narrowing of an artery. Dye (contrast) is injected during the exam.

 

Review Date: 01/05