Inside Artery Disease: Peripheral and Carotid Artery Diseases

Just as the pipes in your house can become clogged over years of use, the human body’s miles of arteries can become narrowed due to atherosclerosis, or the buildup of plaque. This narrowing can lead to two common conditions: peripheral artery disease and carotid artery disease.

While both conditions are caused by atherosclerosis, they affect different parts of the body and have unique symptoms and treatments. The good news is that early detection and treatment can help prevent serious complications like stroke, leg pain and tissue loss.

Peripheral artery disease 

This is a fairly common condition as you age that affects arteries in the legs and sometimes arms. Most of the time it is asymptomatic, but a common symptom is claudication, leg pain that occurs during exercise and subsides with rest. Peripheral artery disease can also cause tissue loss and wounds that are difficult to heal, that can lead to limb loss if not treated.

If you have diabetes, smoke or are over 65, it’s important to get screened for peripheral artery disease. You should also get screened if you have had an abnormal pulse exam or a diagnosis of coronary artery disease.

Screening 

A simple and painless test called the ankle brachial index (ABI) can detect peripheral artery disease. It involves measuring blood pressure in the upper arm and the ankle using a blood pressure cuff and Doppler ultrasound device. The ABI is calculated by dividing the ankle blood pressure by the arm blood pressure. 

Treatment

The first step to treating peripheral artery disease is managing existing medical conditions and risk factors, such as diabetes and high blood pressure, and encouraging healthy habits like regular exercise and a healthy diet. 

Treatment typically includes aspirin and a high-dose statin medication. Starting that regimen early has been shown to stabilize peripheral artery disaese. In more severe cases, surgical options include an endovascular procedure in which a catheter is inserted into the blocked artery and a balloon is used to widen the narrowed area, or open surgery to reroute blood flow around the blocked area by implanting a bypass graft of a healthy blood vessel from another part of the body.

Carotid artery disease 

This condition affects the carotid arteries of the neck, the major blood vessels that carry blood to the brain. If plaque that has built up in a carotid artery breaks off and travels to the brain, it can block a blood vessel and cause a stroke. 

Symptoms of carotid artery disease include stroke and transient ischemic attack (TIA), also known as a mini-stroke, which causes temporary neurological symptoms like weakness, numbness, or speech difficulties. 

Early detection and treatment of carotid artery disease are crucial to prevent stroke and other serious complications. It’s important to screen those at high risk, including people over age 65, those with high blood pressure and/or high cholesterol and those with previous carotid artery disease.

Screening

A carotid duplex ultrasound is a painless test that uses sound waves to create images of the carotid arteries. This test can identify areas of narrowing or blockage, as well as abnormal blood flow patterns.

Treatment

Several procedures can be used to treat carotid artery disease:

• Carotid endarterectomy (CEA). This surgical procedure involves removing plaque from the carotid artery. It is the most commonly performed procedure and has the lowest stroke risk.
• Transcarotid artery revascularization (TCAR). This minimally invasive procedure uses a small incision to access the carotid artery and insert a stent to open it up.
• Transfemoral carotid stenting (TF-CAS). This procedure involves inserting a stent from the groin into the carotid artery. It is only recommended for high-risk patients.

How to Prevent Artery Disease

Several risk factors contribute to both peripheral artery disease and carotid artery disease, including age, high cholesterol, high blood pressure, diabetes, family history, obesity, physical inactivity, poor diet and smoking. Preventing these conditions involves addressing these risk factors through:

• Optimal medical management. Control diabetes, high cholesterol, high blood pressure and weight.
• Quitting smoking. Smoking significantly increases the risk of both conditions.
• Regular exercise. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
• Healthy diet. Choose a diet rich in fruits, vegetables, and whole grains, and low in saturated and trans fats, cholesterol, and sodium.

By understanding the risk factors, symptoms, and treatment options for these conditions, you can take steps to protect your cardiovascular health and reduce your risk of serious complications. If you have concerns, talk to your provider about how you can improve your vascular health.