Articles

PAD is a condition that is associated with the narrowing of arteries and this results in the reduction of blood supply to the limbs. It is important to diagnose PAD at an early stage because its severe complications can be avoided, and the quality of life of the patients can be significantly enhanced. Even though PAD is a severe condition, some patients may not show any symptoms in the early stages.

Screening for PAD is important because it enables the identification of the condition at an early stage and this is helpful in preventing the advancement of the disease as well as the occurrence of severe complications like stroke, heart attack and cardiovascular diseases. PAD is often associated with the presence of atherosclerosis, a disease characterized by the formation of plaques in the arteries of the entire body. This can lead to severe cardiovascular episodes if the problem is not addressed.

Screening for PAD can be done to those with risk factors for PAD including smoking, diabetes, hypertension, hyperlipidemia, age, and family history of cardiovascular diseases. Such an approach can be useful in the prevention and control of PAD and overall health of patients in the long run.

Screening Methods for PAD

Several techniques are used in screening for PAD, which can identify the disease and its stage in asymptomatic patients. Such techniques include, physical examinations, imaging studies, and blood flow studies.

Physical Examination

A thorough physical examination is the first step in screening for PAD. This examination includes:

• Checking the Foot for Ulcers or Callosity: People with diabetes should check their feet daily for signs of ulcers or thick skin (callosity) as these may be signs of poor circulation and PAD. Such areas are vulnerable to injury and slow healing and if not treated, they are likely to develop into more serious complications.
• Assessing Distal Foot Pulses: Palpation of the pulses in the foot, namely the dorsalis pedis and posterior tibial pulses, can give information on the quality of blood flow. Lack of or irregular pulse could point to arterial occlusion and poor blood flow.

Duplex Ultrasound Arterial Scan

Duplex ultrasound arterial scan is a type of diagnostic procedure that involves using sound waves to produce images of arteries in the legs. This test can be done in the clinic and gives significant information about the level and degree of the arterial occlusion and the amount of blood flow in the affected artery. It can be done by a trained vascular surgeon or sonographer and the information thus obtained can be used in the management of the patient with PAD.

Ankle-Brachial Pressure Index (ABPI)

The Ankle-Brachial Pressure Index (ABPI) is a simple procedure that involves measuring the blood pressure in the ankle and the arm. The ABPI is calculated by taking the systolic blood pressure at the ankle and dividing it by the systolic blood pressure in the arm. A lower ABPI suggests that the blood circulation to the legs is poor and there could be PAD.

An ABPI of 1.0 to 1.4 is considered normal, while an ABPI of less than 0.9 indicates PAD. An ABPI of less than 0.4 suggests severe PAD, which requires immediate medical attention. This test is particularly useful for identifying PAD in its early stages and can be performed in a primary care setting.

Early detection of Peripheral Artery Disease is critical for preventing severe complications and improving long-term health outcomes. Screening for PAD in individuals with risk factors, even in the absence of symptoms, allows for timely intervention and effective management of the disease. Through physical examinations, imaging tests, and blood flow assessments, vascular doctors can identify PAD early and recommend appropriate treatments.

By adopting healthy lifestyle changes, taking prescribed medications, and, if necessary, undergoing surgical interventions, individuals with PAD can manage their condition effectively and reduce the risk of serious cardiovascular events. If you are at risk for PAD or have concerns about your vascular health, consult with your healthcare provider to discuss screening and preventive measures.