Westchester Sugery
Specializing in general and vascular surgery - minimally invasive, maximum results.
Specialty Orthopaedics

Arterial Occlusive Disease

Atheroclerosis, or hardening of the arteries, is caused by the accumulation of a fatty substance called plaque on the inside of the walls of the arteries. This is a condition that affects up to 35% of Americans. Atherosclerosis can cause the narrowing of any of the arteries throughout the body, decreasing blood supply to a particular limb or organ.

Narrowing of the arteries decreases the blood supply to the muscles and tissues in the surrounding area, resulting in poor circulation. Lower extremity arterial occlusive disease (occurring in the legs and feet) is often present in conjunction with other conditions, such as carotid artery disease and heart disease.

Risk factors for arterial occlusive disease include:

  • Family history of atherosclerosis
  • High blood pressure
  • Diabetes
  • High cholesterol
  • Advanced age
  • Sedentary lifestyle
  • Smoking

How is Lower Extremity Arterial Occlusive Disease Diagnosed?

Symptoms depend on the organ affected, severity of disease and the suddenness of the block. The symptoms of lower extremity arterial occlusive disease include:

  • Pain in the calves or thighs while walking
  • Pain in the feet at rest
  • Coolness of legs and feet
  • Poor healing of wounds in the extremity
  • Ulcers of the feet and legs
  • Black discoloration of the toes or skin (gangrene)

Pain in the calves or thighs while walking is the most common symptom of lower extremity occlusive disease. Some people may also experience numbness, weakness, or cold in the feet or legs. As the disease progresses, pain may also be felt at rest in the toes and ulcers may develop. These ulcers can turn gangrenous if untreated.

In order to diagnose the severity of the condition, the patient’s blood pressure is taken in the arm and compared to the blood pressure measurement taken in the ankle. The result of this test, called the ankle brachial index (ABI) will evaluate the extent to which the blood supply is limited in the leg.

Imaging tests may also be necessary to determine the location and the extent of the arterial narrowing (stenosis) in the legs. These tests may include angiography or Magnetic Resonance Angiography (MRA).

How is Lower Extremity Arterial Occlusive Disease Treated?

If symptoms are mild to moderate, the disease can be well managed by lifestyle changes such as smoking cessation, regular exercise, and management of related medical conditions such as diabetes, high blood pressure and high cholesterol levels. Exercise can help tremendously in relieving symptoms. Blood-thinning drugs or other kinds of medication may also be prescribed.

In some cases, a procedure may be required to relieve the narrowing in the artery and to restore blood flow to the leg. The arterial stenosis may be treated using minimally invasive procedures such as angioplasty and stenting to improve blood supply to the affected extremity.

However, if the disease is advanced, or if it occurs in an artery that is difficult to reach with a catheter, arterial bypass surgery may be necessary in order to restore blood flow.