Arterial Insufficiency

What is arterial insufficiency?

Arterial insufficiency is reduced blood flow through one or more of your arteries. It happens when your artery becomes narrowed or blocked. Atherosclerosis (plaque buildup) is the most common cause.

Your arteries are the blood vessels that carry oxygen-rich blood from your heart to the rest of your body. Your organs and tissues rely on this supply of blood to function. So, when your arteries can’t send enough blood to your body, you’re at risk of serious complications.

There are two main forms of arterial insufficiency:

• Acute arterial insufficiency: Something (usually a blood clot) suddenly slows or stops blood flow. This is a medical emergency that needs immediate care.
• Chronic arterial insufficiency: An underlying condition (usually atherosclerosis) gradually slows blood flow. As time goes on, symptoms get worse and you face a higher risk of complications.

Early diagnosis and treatment of arterial insufficiency can lower your risk of complications.

How does arterial insufficiency affect my body?

Arterial insufficiency reduces blood flow to many different parts of your body, including your major organs and limbs. How arterial insufficiency affects your body depends on which arteries are narrowed or blocked.

Narrowing or blockage in your:

• Carotid or vertebral arteries, like in carotid artery disease, affects your brain.
• Aorta, like an abdominal aortic aneurysm or a thoracic aortic aneurysm, affects your chest, back and belly.
• Coronary arteries, as in coronary artery disease, affects your heart.
• Superior mesenteric artery, as in mesenteric artery stenosis, affects your small intestine.
• Renal artery, as in renal artery disease, affects your kidneys.
• The arteries in your legs, as in peripheral artery disease, affects your legs and feet.
• Pulmonary arteries, like a pulmonary embolism, affects your lungs.

Keep in mind that arterial insufficiency ultimately affects every part of your body. You may notice symptoms in the part of your body closest to the artery that’s the most blocked, but the same process leading to arterial insufficiency in that area may be happening in other parts of the body. For example, if you have chronic arterial insufficiency in your leg from atherosclerosis (plaque buildup), you’re at higher risk of having it in your heart as well.

Every part of your body needs oxygen to survive. When an organ or tissue is suddenly deprived of oxygen, as with acute arterial insufficiency, it can fail within a matter of hours. As a result, arterial insufficiency can lead to life-threatening emergencies including:

• Critical limb ischemia: Blocked blood flow to your hands, legs or feet.
• Heart attack: Blocked blood flow to your heart.
• Pulmonary embolism: Blocked blood flow in your lungs.
• Stroke: Blocked blood flow to your brain.

Arterial insufficiency can be fatal if not treated. That’s why it’s important to learn the signs and symptoms and talk with your provider about your risks.

What is the difference between arterial and venous insufficiency?

Arterial insufficiency refers to blood flow problems in your arteries. Venous insufficiency refers to blood flow problems in your veins. Your arteries carry oxygen-rich blood away from your heart to the rest of your body. Your veins carry oxygen-poor blood back to your heart.

Both conditions affect blood flow, but they have different causes. Plaque buildup in your arteries causes arterial insufficiency. Damage to the veins in your legs causes venous insufficiency.

Arterial insufficiency can happen anywhere in your body. Venous insufficiency affects your legs.

Both conditions can cause pain or discomfort in your legs. If your legs feel achy, heavy, swollen or tired, see your provider to discuss your symptoms and their cause.

What are the signs and symptoms of arterial insufficiency?

Some people have no symptoms at all until the condition progresses far or leads to a medical emergency. Others have signs and symptoms that include:

• Dizziness: Feeling off-balance.
• Intermittent claudication: Leg pain that starts during activity and stops when you rest.
• Pain in your feet or toes: A burning or aching sensation when you’re resting.
• Skin color and texture changes: Flaking, itching or discolored skin on your legs and feet.
• Stomach pain: Discomfort that consistently begins 15 to 20 minutes after finishing a meal and lasts a couple of hours before going away.
• Ulcers: Open sores on your legs and feet (often around your ankle) that indicate blood flow problems.
• Weight loss: Unplanned drop in your weight.

You may have narrowed or blocked arteries in more than one part of your body. For example, people who have peripheral artery disease (PAD) are more likely than others to have coronary artery disease. So, you may have a combination of symptoms that points to a range of problems. That’s why it’s essential to tell your provider about any symptoms as soon as you notice them, even if they seem mild.

Call 911 or your local emergency number immediately if you have any of the following symptoms. These are symptoms of a medical emergency:

• Chest pain or tightness.
• Double vision or loss of vision.
• Fainting.
• Gangrene.
• Pale, clammy or blue skin.
• Rapid pulse.
• Slurred speech.
• Sudden, sharp pain in your chest, arm, shoulder, neck or jaw.
• Sudden, unexplained shortness of breath.
• Sudden pain or discomfort in your shoulders, neck, belly, and/or back with no other clear cause.

Some symptoms may prevent you from making a call. Consider having a medical alert device (like a necklace) with you at all times. Also, tell your family and friends about the signs and symptoms so they can notice them right away and call 911 for you.

What causes arterial insufficiency?

The most common causes of arterial insufficiency are:

• Atherosclerosis: Plaque buildup in your arteries.
• Thrombosis: Blood clots in your arteries.

How is arterial insufficiency diagnosed?

Providers diagnose arterial insufficiency through a medical history and physical exam. Your provider will ask you many questions to learn as much as possible about your condition. Some questions they may ask include:

• What symptoms do you have?
• How long have you had these symptoms?
• Where do you feel pain?
• Do the symptoms come and go? When do you notice them?
• What makes the symptoms go away?

Your provider will also talk with you about:

• Your medical history.
• Medical history of your biological family members.
• Other conditions you have now.
• Medications you’re taking.

During your physical exam, your provider may:

• Ask you to smile to check for any facial drooping.
• Check your pulse in multiple spots throughout your body. This may include your chest, wrists and ankles.
• Draw blood to check many different levels that could indicate artery disease.
• Examine your eyes and vision.
• Look for changes in your skin color or texture.
• Look for ulcers on your skin.
• Measure your blood pressure in both arms.

Your provider will learn a lot from this exam. But they may also order tests to learn even more about your arteries.

What tests diagnose arterial insufficiency?

Tests that help diagnose arterial insufficiency in various parts of your body include:

• Ankle-brachial index: Measures the blood pressure in your lower legs versus the blood pressure in your arms. Checks how well blood is flowing in your leg arteries.
• Computed tomography angiogram (CTA): Helps find blockages by creating 3D pictures of the blood supply to your heart (coronary arteries), arms, legs or gut.
• Echocardiogram (echo): Uses sound waves to check your heart function.
• Electrocardiogram (ECG/EKG): Records your heart’s electrical activity. Finds problems with blood flow or heart rhythm.
• Pulse volume recording: Measures blood volume changes in your legs. Finds blockages.
• Vascular ultrasound: Uses sound waves to create images of your arteries, including your carotid arteries. Finds blockages.

What is the treatment for arterial insufficiency?

Treatment for atrial insufficiency depends on the cause and the level of severity. Talk with your provider about the treatment that’s best for you. Treatments include:

• Atherectomy.
• Carotid endarterectomy.
• Coronary angioplasty.
• Coronary artery bypass grafting (CABG).
• Lifestyle changes related to physical activity and what you eat.
• Medication to control blood pressure, cholesterol and blood glucose levels.
• Medication to reduce your risk of blood clots (anticoagulants).
• Stents.

What are the risk factors for arterial insufficiency?

Arterial insufficiency can happen to anyone, but some people face a higher risk. You’re more likely to develop arterial insufficiency if you have these medical conditions:

• Atrial fibrillation.
• Diabetes.
• Hyperlipidemia (high cholesterol).
• Hypertension (high blood pressure).
• Protein C deficiency.
• Protein S deficiency.
• Thrombophilia.
• Trousseau syndrome (cancer-associated thrombosis).

Other risk factors include:

• Being over age 60.
• Pregnancy.
• Smoking and tobacco use.
• Estrogen-based birth control medication.

How can I prevent arterial insufficiency?

Lifestyle factors can make a huge difference in lowering your risk for arterial insufficiency. Things you can do include:

• Add physical activity to your daily routine. Aim to walk 30 minutes a day five days a week. Be sure to talk with your provider before starting a new exercise routine.
• Don’t smoke or use tobacco. This includes vaping and smokeless tobacco.
• Follow a heart-healthy diet.
• Limit alcohol Men and people designated male at birth should have no more than two drinks per day. Women and people designated female at birth should have no more than one drink per day.
• Manage your weight. Talk with your provider about what weight is healthy for you.
• Take your medications as prescribed.
• Visit your provider for regular check-ups at least once a year.

What can I expect if I have arterial insufficiency?

In many cases, you can manage arterial insufficiency with treatment. Your outlook depends on your specific condition and how far it’s progressed. Talk with your provider about your prognosis and how best to manage your condition.

How do I take care of myself if I have arterial insufficiency?

Tips for living with arterial insufficiency include:

• Create a physical activity plan. There’s no one-size-fits-all approach. Find an activity you enjoy. It could be dancing, ice skating or walking in the park. Also, find ways to add more steps to your daily routine. Always check with your provider about what types of exercise are safe for you.
• Explore healthier food options. Check into the Mediterranean and DASH.
• Practice good skin hygiene. This is especially important if you have PAD, diabetes-related neuropathy or any other peripheral neuropathy. Wash and moisturize your legs and feet every day. Check for signs of color changes, cracks or ulcers.
• Quit smoking and using tobacco. Ask your provider for resources to help you quit.
• Wear comfortable shoes. The shoes should be supportive and fit well.

When should I see my healthcare provider?

Keep all your appointments and follow-ups. Your provider will let you know how often you need to come in.

Also, call your provider right away if you notice any new or changing symptoms. It may be helpful to print out a list of symptoms and keep them nearby. In the hustle and bustle of daily life, it’s easy to miss a symptom or brush it off as no big deal. Stay aware of the things you should look out for, and share this information with your loved ones.

A note from Cleveland Clinic

If you’ve learned you have arterial insufficiency, you might be wondering, “how can I fix it?” That’s often a person’s first reaction to any health problem. You may wish you could go back in time and do something differently. But this is a time to look forward, not back.

Focus on the here and now. What changes can you make right away? Which ones are most important? Ask your provider for guidance on lifestyle changes and treatment. Most of all, remember that you don’t have to do this alone. Your provider and your entire care team are there to support you in improving the health of your arteries.