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Peripheral artery disease

Morbus arteriarum periphericarum · Ischemická choroba dolních končetin

What it is

The same plaque as in the heart, narrowing the leg arteries.

Symptoms & signs

  • Calf cramp on walking that stops on rest
  • cold feet
  • hair loss on legs
  • non-healing ulcers
  • rest pain at night

🚩 Get help if…

  • call 112 / 911 now Sudden cold, pale, painful leg or foot
  • call 112 / 911 now Numb or weak leg that cannot move normally
  • see a doctor soon Pain in the foot at rest, worse lying down
  • see a doctor soon Foot sore that won't heal or black skin on the toes

Where it strikes

Medical treatment

  • Supervised exercise therapy
  • statin
  • antiplatelet
  • cilostazol
  • angioplasty or bypass for critical limb ischaemia
  • drug-coated balloons — FDA-approved since 2014; a 2018 death signal from paclitaxel was not confirmed in later analyses mixed evidence

Natural & lifestyle

  • Walk-through-pain programme (best evidence of all)
  • stop smoking
  • foot care
  • diabetes control

Emerging & experimental

  • Gene and stem-cell angiogenesis therapy
  • paclitaxel-free scaffolds

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Ginkgo biloba — small trials, modest gain in walking distance mixed evidence
  • L-arginine — the longer NO-PAIN trial found worse walking, not better not confirmed in trials
  • Chelation (EDTA) — TACT hinted at fewer amputations in diabetics; not confirmed mixed evidence
  • Intermittent pneumatic compression at home — used in clinics; evidence limited anecdotal / traditional

ICD codes