Global Perspectives and Epidemiological Research of Peripheral Artery Disease (PAD)

A significant vascular condition, peripheral arterial disease (PAD) is a sign of extensive atherosclerosis in other vascular areas, including the coronary and brain circulations. Significant mortality and morbidity are experienced by those who have PAD, which is also linked to higher hospitalization rates and a lower standard of living.

Approximately 40 to 45 million Americans are estimated to be among the 200 million individuals globally who are affected by peripheral vascular disease as of June 2023, according to the NIH. While the condition is rare in canger populations, over 20% of those over 80 have PAD, indicating a dramatic increase in frequency. Research on gender disparities is contradictory. Men were more likely than women to experience intermittent claudication (IC) in the Framingham trial (1.9% versus 0.8%; ratio 2.38). Intermittent claudication is the most typical symptom among PAD patients (IC). This result was in line with the Rotterdam study, which discovered that the prevalence of IC was 2.2% in men and 1.2% in women and that males were 1.83 times more likely to have it than women. However, when the ankle-brachial pressure index (ABI) is used to diagnose PAD, there is a shift in prevalence that is specific to gender.

Furthermore, CADI research states that, based on an Ankle Brachial Pressure Index, or ABPI of less than 0.9, the overall prevalence of PAD was found to be 3% in an Indian population-based study. This is significantly lower than the 6–18% prevalence found in Europe. In contrast to Europids, there is no correlation between PAD and CAD in Indians; the prevalence of CAD was comparable in those who had PAD and those who did not.

Diseases of the arteries that do not affect the heart or brain are referred to as peripheral artery disease. Atherosclerosis, or plaque, is typically the cause of the narrowing or blockage of the arteries that supply oxygen-rich blood to every part of the body in PAD. While arteries that supply blood to the head, arms, kidneys, and gastrointestinal (GI) tract are most frequently affected by PAD, arteries in the legs are also susceptible.

Atherosclerosis usually becomes the cause of peripheral artery disease. Radiation exposure, trauma, and blood vessel inflammation are possible additional causes.

Diabetes, smoking, obesity (defined as a body mass index greater than 30), high blood pressure, elevated cholesterol Aging older, particularly after the age of 50, Peripheral artery disease, heart disease, or stroke in the family high concentrations of homocysteine, this protein aids in tissue growth and maintenance.

Sign & Symptoms

About one in ten people with peripheral artery disease (PAD) report experiencing unpleasant cramps or weariness in the legs, hip, thigh, or calf muscles after walking or ascending stairs. These symptoms are usually resolved with brief rest intervals. However, many patients with PAD have minimal symptoms or no symptoms at all.it is ailment referred as intermittent claudication.

Additional indications consist of alterations in leg colour, alterations to the nails, chilliness in the foot or lower leg, particularly when contrasted with the other leg baldness on the legs and feet, legs feeling weak or numb, and unbearable sores on the legs, foot, or toes.

Diagnostic Analysis of PAD

• Anckel-Brachial Index

Ankle Brachial Index (ABI) is a useful statistic for diagnosing peripheral artery disease (PAD). A simple test to compare blood pressure in the upper and lower limbs is the ABI. By dividing the blood pressure in an ankle artery by the blood pressure in an arm artery, medical professionals compute an average blood pressure (ABI). The ABI is the outcome. A person has peripheral artery disease (PAD) in the blood arteries in their legs if this ratio is less than 0.9.

Legs and feet might not be receiving as much blood as they require if ABI is low. However, an ABI test cannot identify the precise blood arteries that are constricted or obstructed.

• Pulse Volume Recording

Blood flow in the legs is measured with a pulse volume recording test. Ultrasound, or high-frequency sound waves, is used to assess arterial circulation. There are no needles or skin incisions needed for a PVR test because it is non-invasive and painless. It is also known as a segmental pressure test or pulse volume plethysmography.

 Imaging Tests

To obtain a clearer image of the blood vessels in the legs and feet, doctor also prescribe angiography as part of an imaging test. A variety of angiography types exist:

• CT Angiography

With CT angiography, the arteries in the legs, pelvis, and belly are seen in great detail thanks to a CT scanner. Patients with pacemakers or stents benefit most from this examination.

• Magnetic Resonance Angiography (MRA)

MRA investigates the anatomy of the leg arteries Those with metal implants in their bodies should not do this MRA test.

• Catheter Based Angiography

With catheter-based angiography, medical professionals see into leg arteries. A catheter, or tube, is inserted into groin artery by a doctor, who then guides it to the injured location. After the catheter has been used to release a particular dye, X-rays are taken. When other tests have failed or there is significant pain in the legs or feet, the physician recommends this procedure if PAD therapies are not working.

• Vascular Ultrasound

A non-invasive test is a vascular ultrasound, sometimes known as a duplex scan. This test demonstrates to medical professionals how blood flows through the arms, neck, and legs. High-frequency sound waves provide precise detailed pictures of blood vessels and soft tissue.

• Arterial Duplex Ultrasound

A medical professional applies high-frequency sound waves to the lower extremities using a portable device. Results indicate areas that are blocked or narrowed. This test does not assess blood pressure, in contrast to PVR.

Diagnostic Market Players and Products

Treatment Analysis of PAD

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Medicines

In addition to treating the underlying causes of PAD, many medications lower chance of getting another CVD.

• Statins- Statins delays the symptomatic accumulation of plaque in the arteries by lowering blood levels of cholesterol and certain fats. Additionally, statins reduce chance of PAD complications. Muscle soreness or injury is one of the uncommon side effects. Statin use has several adverse effects, such as indigestion, headaches, nausea, and muscle aches.
• Antihypertensive- Antihypertensives are a class of drugs used to treat hypertension or elevated blood pressure. Angiotensin-converting enzyme (ACE) inhibitors are a prevalent class of antihypertensive medication that reduce blood pressure and stop blood arteries from constricting. One of the ACE inhibitor's side effects is dizziness, tiredness, persistent cough, etc. If the side effect grows severe then Angiotensin Receptor Blockers (ARB) are recommended.
• Antiplatelet Medicine- Antiplatelet medications, such clopidogrel or aspirin, inhibit blood clots from developing and further constriction of the arteries. The risk of a heart attack or stroke is also decreased by these medications. An allergic response or bleeding are examples of potential adverse effects. Additionally, cilostazol, one kind of antiplatelet medication, reduces discomfort and facilitates walking. Cilostazol causes a headache, dizziness, diarrhea, and palpitations in addition to other adverse effects. To help avoid blood clots, providers also suggest anticoagulant medications, sometimes known as blood thinners.
• Naftidrofuryl Oxalate- This medication, which enhances blood flow throughout the body, is very infrequently taken by people who would rather avoid surgery. It is also applied if an exercise program under supervision hasn't improved the patient's condition enough. To determine whether naftidrofuryl oxalate improves symptoms, patients are typically advised to take medication for three to six months. This is the moment at which the therapy will end if it is not working.

Surgeries and Procedure

In certain instances, a surgery for restoring blood flow to legs' arteries is advised. This is called revascularization. If leg pain is so bad that it keeps patient from doing daily tasks or if the treatments tried haven't made a difference in symptoms, revascularization might be necessary.

For PAD, there are two primary revascularization therapy options.

• Angioplasty-

 Angioplasty is a technique in which a physician uses a balloon to unblock a blocked or constricted artery. However, most contemporary angioplasty treatments also include the insertion of a small wire mesh tube, known as a stent, into the artery as part of the process. To improve blood flow, the stent remained in situ indefinitely.

Percutaneous transluminal coronary angioplasty (PTCA) is another name for coronary angioplasty. Percutaneous coronary intervention (PCI) is the common term used to describe the combination of coronary angioplasty and stenting. After an angioplasty, the coronary arteries' blood flow usually improves. Many reports notable improvements in their symptoms and increased capacity following the operation.

• Artery Bypass Graft-

A coronary artery bypass transplant entails joining a blood vessel from an alternate body part—typically the arm, leg, or chest—to the coronary artery above and below the restricted section or blockage.

In situations where angioplasty is less likely to be successful, bypass surgery is done to relieve excruciating pain, close wounds, or preserve a damaged foot or leg.

Change in Lifestyle and Habits

• Exercise- Research indicates that engaging in regular exercise will lessen the frequency and severity of PAD symptoms, as well as lower the chance of getting another CVD.
• Quit Smoking- The primary risk factor for PAD is smoking. Both symptoms and chance of complications goes down when stop. It's also critical to stay away from second-hand smoke.
• Reducing alcohol use, maintaining a healthy weight, eating a balanced diet, and stress management are all crucial components in the prevention and treatment of PAD.

Treatment Market Players

Angioplasty and Bypass Surgery

Bypass surgery is more intrusive than an angioplasty. It's a day treatment usually done under local anaesthesia and doesn't require any big incisions in the body. This enables faster recovery and allows the patient to return home the same day of the procedure.

Because of this, angioplasty is typically favoured over bypass surgery, unless it is deemed inappropriate or has demonstrated a history of failure.

Still, most people believe that a bypass provides longer-lasting results than an angioplasty. This indicates that the process requires fewer repeats than an angioplasty.

There is a slight chance of major side effects from both angioplasty and bypass surgery, including heart attacks, strokes, and even death. Although there aren't many studies comparing angioplasty and bypass surgery for PAD, there is some data that suggests both procedures have a comparable risk of major complications.

PAD Market Analysis and Insight

The peripheral arterial disease (PAD) market is examined, and the previously mentioned country, treatment type, administration route, end users, and distribution channel are used to provide market size insights and trends.

The peripheral arterial disease (PAD) market is dominated by North America because of the region's rapid advancement in technology. Moreover, during the forecast period, the peripheral arterial disease (PAD) market in the region will grow at a faster rate due to the occurrence of novel drug molecules that improve treatment procedures.

The market for peripheral arterial disease (PAD) is expected to grow significantly in Asia-Pacific because of an increase in the patient pool. Furthermore, it is expected that increased investment in the healthcare sector will fuel the peripheral arterial disease (PAD) market's expansion in the area over the next several years.

Regulatory Framework for Peripheral Artery Disease

DiseaseLandscape Insights considers the regulatory environment for PAD disease in different countries. The key player receives information from DLI regarding import/export laws, risk assessment laws, and surveillance. Market participants will undoubtedly prevent and respond to PAD outbreaks for the safety and well-being of the affected population by selecting DLI services.

The FDA approved Cardio Flow, Inc.'s Freedom Flow Peripheral Guidewire in June 2022. Cardio Flow, Inc. is a medical device company that makes minimally invasive peripheral vascular devices to treat peripheral artery disease (PAD).

The US Food and Drug Administration (FDA) designated Cook Medical as a breakthrough device in January 2022 for a novel drug-eluting below-the-knee (BTK) stent. The purpose of this new stent is to treat patients with persistent ischemia that poses a threat to the limb.

Becton, Dickinson, and Company acquired Straub Medical AG, a private corporation, in June 2020. Straub Medical AG develops medical atherectomy and thrombectomy devices to treat peripheral arterial diseases (PAD) and vein problems.

Clinical Trial Assessment

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The aid of DLI facilitates the establishment and execution of clinical trials for novel therapies and drugs, patient recruitment tactics, regulatory compliance, assuring favorable trial outcomes, etc.

The table below lists the study names for the clinical trials that are currently in progress, along with the phases in which they are being carried out:

Conclusion

DiseaseLandscape Insights (DLI) helps industry participants develop and carry out feasible treatment programmes to stop and treat instances of PAD. In addition, due to increased awareness and anticipated epidemics, there is growing need for diagnostic tools and clinical evaluations. DLI provides key players in the manufacturing and diagnosis with vital information and experience.

DLI motivates the leaders to conduct qualitative research, investigate the manufacturing companies, and discover the raw material sources. DLI services helps all market participants gain a better foothold in the Osteonecrosis Domain and keep one step ahead of the competition.