A quick overview:
What is PAD / “Window-shopper’s disease”?
Peripheral Arterial Occlusive Disease (PAOD, or PAD), like diabetes mellitus, is one of the possible concomitant diseases of patients with vein disorders. It is a progressive circulatory disorder afflicting the arteries – mostly in the legs. PAD is also colloquially referred to as “calcified arteries”.
If the arteries become narrowed, not enough blood and, therefore, not enough oxygen and nutrients reach the affected parts of the body. The most severe form of PAD results in tissue death, which may require amputation. The common name for this is “smoker’s leg”.
According to Fontaine, PAD is divided into four stages:
- Stage I: asymptomatic
- Stage IIa: mild intermittent claudication (“intermittent claudication”), walking distance > 200m
- Stage IIb: moderate intermittent claudication (“intermittent claudication”), walking distance < 200m
- Stage III: ischaemic pain when at rest
- Stage IV: Ulcer (ulcer), gangrene (for example, with smoker’s leg).
Note: Patients with PAD have, among other things, an increased risk of suffering a heart attack or stroke. Therefore, a doctor should always be consulted if PAD is suspected.
Common symptoms and signs of window-shopper’s disease
The tricky thing: In the early stages, the circulatory disorder, also known as “window-shopper’s disease”, often goes unnoticed. Initially, those affected have no complaints and the body can secure the blood supply by the collateral vessels.
Only later does the so-called ischaemic pain occur during prolonged walking. It is caused by a lack of oxygen supply to the legs and causes sufferers to stop after walking certain distances (Claudicatio intermittens = intermittent claudication) – like with “window shopping”. This is why PAD is also commonly referred to as “window-shopper’s disease”. After a rest, the pain subsides, which can occur in the thigh, calf or foot. If the disease progresses further, the legs begin to hurt when at rest.
Other signs may include:
- Trophic disorders (insufficient oxygen / nutrient supply of the tissue)
- Numbness
- Pale, cool skin
- Sensitive skin
- Cold hands and feet
- Sensitivity loss
- Delayed wound healing
- Sandpaper-like hyperkeratosis (the cornification of the skin)
- Atrophy (tissue loss) on the dorsum of the foot
Causes and risk factors: How does PAD develop?
In most cases, PAD, which is a chronic disease, is caused by arteriosclerosis (the hardening of the arteries). It is caused by changes and fatty deposits (plaques) on the inner walls of the arteries. This narrowing impedes the transport of blood to the tissue.
If these deposits become detached, the arteries can become completely blocked (atherothrombosis). In the coronary vessels, this can manifest itself as a heart attack – and in the brain as a stroke.
The primary risk factors for atherosclerosis are:
- Smoking
- High blood pressure
- Morbid obesity
- Diabetes mellitus
- Too high a cholesterol level
- Lack of exercise
Less common causes can include vascular malformations, tumours, trauma or radiation damage, for example.
Diagnosis: How does a doctor diagnose PAD?
First, the doctor asks questions about your medical history and any existing complaints. Then, the doctor examines the body’s pulse on the leg and foot, checks the skin and rules out other causes for existing complaints – for example, an orthopaedic incorrect positioning or damage to the nerves.
The majority of examinations are done with ultrasound. Furthermore, blood pressure measurement on the leg and arm to determine the so-called ankle-brachial index (ABI) is an elementary component of diagnostics.
Which doctor treats a PAD?
Depending on the situation, the point of contact is the GP, the cardiologist, the Phlebologist, the vascular surgeon or the angiologist.
Treatment for PAD: What helps with circulatory problems in the legs?
PAD cannot be cured. Discuss with your doctor which treatment options are best suited to your stage of the disease. For example, medication such as blood flow stimulants or surgery to restore a better flow (stent placement, bypass surgery) may be considered. Also, ask what you can do yourself to prevent the vascular calcification from progressing further.
Adopting a healthy lifestyle: This is how you support your therapy and prevent progression of the disease
Do not smoke.
Walk and move around a lot.
Eat a balanced diet.
If necessary: Reduce your weight.
Have your doctor compile an exercise- and walking programme.
Keep your check-up appointments and take your medication as prescribed by your doctor.
PAD and diabetes: Common concomitant afflictions of patients with venous diseases
The basic therapy for venous diseases is medical compression therapy in combination with exercise. However, caution is required in compression therapy for venous disease if the patient is also affected by PAD and / or diabetes mellitus: Circulatory disorders and reduced pressure- and pain sensation make therapy with medical compression stockings more difficult.
Nevertheless, compression therapy should be continued: When used consistently, medical compression stockings help to prevent (or improve) vein-related symptoms – such as pain, swelling or heaviness: Venous patients with PAD and / or diabetes mellitus, therefore, have special requirements for medical compression stockings.
mediven angio: Safe vein therapy for mild to moderate PAD and diabetes mellitus
The mediven angio* medical compression stocking from medi closes the existing gap in the care process. It has been specially adapted to the needs of these users. Arterial blood circulation and possible sensitivity disorders (for example, in diabetes) – especially in the foot and toe area – were a particular focus during product development: Therefore, the mediven angio enables effective and safe vein therapy.
- The soft merino wool padding across the entire foot area and up to above the ankles protects and avoids pressure peaks. Simultaneously, it offers optimal thermoregulation and a high degree of user comfort in every season.
- The snug, flat seam in the toe area protects the sensitive bony prominences and relieves pressure on the tips of the toes. Blood circulation to the skin is maintained, which prevents damage to the toes or the formation of skin disorders.
- The ribbed structure provides reliable compression and acts as a guide when donning: When correctly applied, the ribbed structure runs parallel to the tibia.
- The extra-wide cuff provides a secure fit and prevents constriction.
- The discreet look of the mediven angio in the colours caramel and black means that it goes with any wardrobe.
The safety of the medical compression stocking has been confirmed for compression classes 1 and 2.1
Study results: Vein therapy for PAD and diabetes mellitus
mediven angio is the only medical compression stocking whose safety for use for patients with chronic venous disease and concomitant mild- to moderate PAD and/or diabetes mellitus has been scientifically investigated and confirmed in a clinical study. There, it was proven that no skin lesions (for example, pressure marks, constrictions) occurred and that the blood flow in the smallest vessels (= microcirculation including oxygen saturation) remained stable under compression.1
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Sources and remarks:
Sources
1 Rother U et al. Safety of medical compression stockings in patients with diabetes mellitus or peripheral arterial disease. BMJ Open Diab Res Care 2020;8:e001316.
*Intended purpose
Round-knitted medical compression stocking used for compression of the lower extremities, mainly for the treatment of disorders of the venous system.
