One of the most common causes of arterial insufficiency is atherosclerosis or "hardening of the arteries." Fatty material (called plaque) builds up on the walls of your arteries. This causes them to become narrow and stiff. As a result, it is hard for blood to flow through your arteries.

Blood flow may be suddenly stopped due to a blood clot. Clots can form on the plaque or less often travel from another place such as the heart or other artery (also called embolus).

Symptoms depend on where your arteries become narrowed:

• If it affects your heart arteries, you may have chest pain (angina pectoris) or a heart attack.
• If it affects your brain arteries, you may have a transient ischemic attack (TIA) or stroke.
• If it affects the arteries that bring blood to your legs, you may have frequent leg cramping when you walk called claudication.
• If it affects the arteries in your belly area, you may have pain after you eat called abdominal angina (due to mesenteric ischemia).

Goodney PP. Clinical evaluation of the arterial system. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 19.

Libby P. The vascular biology of atherosclerosis. In: Libby P, Bonow RO, Mann, DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 24.

Updated by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.