Learn about peripheral artery disease and its treatments
If you, or someone you know, smokes, has high blood pressure, diabetes, high cholesterol, heart disease, or has a family history of these conditions, chances are strong that peripheral arterial disease, or PAD, will touch your lives. Here we’ll discuss PAD and artery disease treatments. However, to learn about PAD’s evil twin — venous disease and vein disease treatments – please click here. We also treat artery disease in our Endovascular Center. You can find out more here.
Peripheral Artery Disease or PAD
Patients with PAD have blockages in the blood vessels going to their legs. PAD is caused by atherosclerosis — or hardening of the arteries – which is a buildup of plaque, or fatty deposits, in the walls of the blood vessels. This is the same disease that can block arteries going to the heart (coronary artery disease) and the brain (cerebrovascular disease). Therefore, patients with PAD also have an increased risk of having a stroke or heart attack. PAD affects up to 12 million Americans; 12 percent to 20 percent of those over the age of 65.
What Are the Symptoms of PAD?
Pain in the muscles of the legs when walking. Called intermittent claudication (IC) this is the most-common early symptom of PAD. When you have arteries that are blocked by PAD, you can’t get enough extra blood to your muscles, so after walking for a few minutes, your legs may get tired, feel heavy, ache, or begin to hurt forcing you to stop. When you rest, the pain goes away, but it comes back after you walk again for a few more minutes. Mild claudication (IC) may seem like just a nuisance, but it can become very disabling.
Pain in the muscles of the legs even when you are resting, called critical limb ischemia (CLI), is considered severe PAD. Patients with CLI often have pain in their feet or toes. They can also develop ulcers or sores on their feet and ankles, which can progress to dead tissue, or gangrene. Untreated, patients with CLI can eventually lose a leg.
Many patients with PAD have no symptoms at all.
Who Is at Risk for PAD?
Women get peripheral artery disease, but it is more common in men. Risk increases with age. Other risk factors for PAD include:
- High blood pressure
- Family history
After checking your medical history, your doctor from Southeastern Vascular will do a diagnosis involving any combination of the following: check the pulses in your arms and legs, check the blood pressure in your legs, take X-Rays, do an MRI or CT scan of the blood vessels, other.
Treating PAD with One or More Recommendations
Then comes treatment. And, even patients without symptoms need treatment for the disease that causes peripheral artery disease: atherosclerosis. Your doctor will likely recommend one or more of the following, depending on the severity of your peripheral artery disease:
- A mild blood thinner such as aspirin
- A cholesterol-lowering medication
- Blood pressure medicines
- A medication called Cilostazol — helpful for some patients with claudication
- Dietary modifications
- An exercise program
- That you quit smoking
- A surgical artery bypass (uncommon today)
- Minimally invasive endovascular procedures and/or stents that open up blockages (more common)*
*While still done in hospitals, many vascular specialists are now often able to perform these minimally invasive procedures in their ofﬁces. That group includes our team of medical professionals here at Southeastern Vascular. We have the advantage of being able to diagnose and treat patients at our new, state-of-the-art Southeastern Vascular Outpatient Endovascular Center in Hyannis, MA on the Cape.
An angiogram is a test to look at the arteries in the body. Arteries are blood vessels that carry oxygen and nutrients to the body. During an angiogram, a catheter is put into an artery (usually in your groin or arm). Special dye is then given through the catheter and x-ray pictures of blood flow are taken
An angioplasty is a technique when a special balloon is used to open up a narrowed on blocked artery. The balloon is passed across the blockage over a guidewire under x-ray guidance, and then inflated. This procedure is used to open narrow or blocked arteries. The procedure restores blood flow to the area.
A stent is a special wire tube that is placed into a blocked or narrow vessel, holding it open. It is placed into the vessel in a small catheter, under x-ray guidance, and then opened up into the vessel.
An atherectomy is a technique where blood vessels that are blocked by hardening of the arteries are treated with a specialized catheter that removes the plaque and opens up the blood vessel. This is sometimes done with a special laser catheter, and sometimes with a diamond-tipped rotational catheter. It is often combined with angioplasty and stenting for severely blocked arteries.
A mechanical thrombectomy is a technique for unblocking clotted blood vessels. This includes blocked arteries, blocked veins, as well as blocked dialysis grafts. A special catheter is inserted into the vessel under x-ray guidance. This catheter breaks up the clot and suctions it out. Special clot dissolving medications are sometimes used as well.
A venogram is a test to look at the veins in the body. Veins are blood vessels that carry used blood back to the heart. During a venogram, a catheter is put into a vein (usually in your groin or arm). Special dye is then given through the catheter and x-ray pictures of blood flow are taken.
A fistulagram is a test to look at the fistula in your arm. During a fistulagram, a catheter is inserted into the fistula and a special dye is injected. X-rays are then taken of the blood flow through the fistula. If the fistula is narrowed or clotted, it will often be treated at the same time with angioplasty or thrombectomy.
The Venefit™ procedure (formerly called VNUS Closure™), or endovenous radiofrequency ablation, is a minimally invasive procedure resulting in less pain and less bruising compared to traditional vein stripping surgery and laser treatment. It is clinically proven to be an effective means of treating varicose veins and their underlying cause, venous reflux.
Using the Venefit™ system the diseased or damaged vein is closed by inserting a catheter into a vein and heating the vein wall using temperature-controlled radio-frequency energy. This causes the wall to shrink and the vein to close. After the vein closes blood reroutes to healthy veins and the body dissolves the closed vein over time.
The procedure is done in the office, takes about 15 minutes, and patients walk away from the procedure and typically return to their normal activities within a day.
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