Accumulation of fat in legs may lead to amputation

The two most common causes are accumulation of fat within the arteries (atherosclerosis), that reduces the internal diameter of arteries and smoking, that causes spasm to arteries. This disease usually affects the legs . A notable symptom is severe leg pain when the patient walks (medically termed as claudication).

If peripheral artery disease progresses, pain may even occur while at rest or when lying down (ischemic rest pain). It may be intense enough to disrupt the patient’s sleep. Hanging the legs over the edge of the bed or walking around the room may temporarily relieve the pain.

Patients are usually present with the following symptoms such as painful cramps in the hips, thighs or calf muscles while running, walking or climbing stairs (claudication). There are other symptoms such as leg numbness or weakness, cold feet and blisters or ulcers on toes and feet that heal very slowly. Sometimes, there can be symptoms of a change in the colour of legs, hair loss or nail loss and even erectile dysfunction in men.

Factors that increase the risk of developing PAD includes diabetes, smoking, obesity, high blood pressure, high cholesterol and a family history of peripheral artery disease, heart disease or stroke. People who smoke or have diabetes have the greatest risk of developing peripheral artery disease.

Peripheral Artery Disease (PAD) can be diagnosed by Peripheral Doppler Ultrasound, whereby sound waves are used to detect any obstruction in the blood flow. The gold standard remains Angiogram, whereby medical-grade ink is injected into the arteries and real-time images are captured of the arteries, and the exact extent of the block is clearly defined. Other methodologiesinclude Digital Su traction Angiography, CT Angiogram or MR Angiogram.

Primarily focused on identifying and treating the risk factors associated with the disease, especially, diabetes and smokers should be advised to lead a healthy lifestyle by exercising regularly, reducing weight, avoiding fatty foods and stop smoking.

Minimal invasive procedures include Balloon Angioplasty and Stenting, whereby a specialised balloon is inserted into the artery and inflating the balloon thereby expanding the internal diameter and dilating the artery and a stent (a flexible metal coil) is inserted to prevent the artery from getting blocked (restenosis). In advanced cases, where blocks are extremely tight, Bypass Surgery can be performed by connecting the graft/vein that increases the blood supply.

Another form of treatment is Stem Cell Therapy whereby stem cells are injected into the limb to help regenerate the tissues and form new blood vessels to supply the limb (neo vascularisation).

The goal of treatment is to diagnose the disease early and to control the risk factorsand to save the limb and prevent amputation.