00:00
So peripheral artery disease whether it is
in the carotids or in the legs is the result
of narrowing of the arteries by the atherosclerotic
process, the same factors that lead to narrowing
of the coronary arteries cause atherosclerosis
to develop in the peripheral arteries. Indeed
when I see a patient who has coronary disease,
I know they also have atherosclerosis in their
legs and in their carotid arteries, and in
their aorta, their abdominal aorta. There
is a whole variety of other complications
that can occur just because somebody has a
heart attack does not mean that is the only
area that is being affected by atherosclerosis.
00:42
It is a systemic disease that occurs in all
of the arteries and generally causes trouble
in one or multiple arterial beds. The commonest
site for peripheral vascular disease is the
legs and that symptom is of course intermittent
claudication when the patient walks and does
not get enough blood flow in their muscles.
And of course treatment consists of reducing
atherosclerotic risk factors such as smoking,
better control of diabetes and hypertension,
regular exercise, a variety of medicines to
lower cholesterol, control of blood pressure
and sometimes to thin the blood, and at times
when things are quite severe surgery or angioplasty
with a little metal stent to open the artery
using a catheter technique can be done. There
is a lot of good treatments both medical and
interventional, surgical, and angioplasty
for these patients and that is a very simple
reason why because this is the commonest major
disease that we see in developed countries
throughout the world.