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Hardening of the arteries of the body (called atherosclerosis) is a common problem in our society. This is, in fact, the process that causes the artery blockages that result in heart attack and stroke. When these blockages occur in the arteries that give blood and oxygen to the arms and legs, it is called peripheral vascular disease. Although atherosclerosis may develop in the blood vessels of the arms, it is by far more common in the blood vessels of the legs.

When blockages develop in the leg arteries, there is not enough blood flow to the muscles of the leg during exercise. At first, this tends to cause cramping in the leg muscles when walking or running, which tends to go away with rest. This cramping pain is referred to as claudication, which comes from the Latin word, claudus, meaning lame or limping (because of the obvious limitation that occurs when the cramping pain begins).

As the severity of the blockage increases, less and less exertion is needed to cause claudication. When the pain begins to occur at rest, immediate medical attention is necessary to prevent loss of the leg.

The diagnosis of peripheral vascular disease is usually made after obtaining the history and performing a detailed examination of the blood flow to the legs. This should include a measurement of the blood pressure at several sites in each leg, as well as an analysis of the pattern of blood flow in the arteries. This is determined by a technique known as Doppler spectral analysis. Confirmation of the diagnosis is made by arteriography, an X-ray dye test, to actually take X-ray pictures of the arteries to the legs.

The treatment of peripheral vascular disease is determined by the severity of the blockages, their number, and their location. In many instances, medication and an exercise program are adequate to gain relief. In some cases, surgery to repair the artery or bypass the blockages is needed. In the last several years, a technique known as angioplasty has been used successfully to eliminate leg artery blockages without surgery. This method can be used only in special cases, and uses a balloon to open the artery rather than surgery.

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