Peripheral Artery Disease (PAD)
What is Peripheral Artery Disease?
Peripheral artery disease (PAD) is disease of any blood vessel that is not part of the heart or brain. PAD is caused by fatty deposits that can build up in the walls of the arteries (atherosclerosis) and is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs, usually the legs. Conditions related to PAD include: acute limb ischemia; claudication; gangrene / limb salvage; and ulcerative disease.
PAD is usually caused by atherosclerosis. Other causes include blood clots or embolisms, congenital heart disease and inflammation of the blood vessels called vasculitis.
Copyright © Nucleus Medical Media, Inc.
PAD can be hereditary. You also may get PAD if you are overweight or obese, have high blood pressure, diabetes, or high cholesterol. Unhealthy lifestyle choices such as smoking, eating a high-fat diet and not getting enough exercise lead to PAD.
- Cigarette smoking
- High blood pressure or family history of high blood pressure
- Stroke or family history of stroke
- High cholesterol or family history of high cholesterol
- Age 50 or over
- High homocysteine level in blood
- Gender: Male
- Family history of PAD
Symptoms of PAD are related to the organ or part of the body deprived of blood. This includes:
- Pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s) brought on by exercise that goes away when resting
- Numbness and pain of the legs or feet at rest
- Cold hands, legs or feet
- Loss of hair on the legs and/or feet
- Paleness or blueness of the legs
- Weak or absent pulse in the leg
- Sores, ulcer, or infection of the feet and legs that heal slowly
- Erectile dysfunction
- Swelling in lower extremities
- Muscle atrophy
Diagnosis & Treatment
Your doctor will ask about your symptoms and medical history. A physical exam will be done. During the exam, your doctor may:
- Check the strength of the pulse in the leg arteries
- Listen for a whooshing sound in a leg artery or the abdomen using a stethoscope
- Check blood pressure at various points in the leg and compare it to the normal arm blood pressure
- Conduct a treadmill test
- Your bodily fluids may be tested and this can be done with blood tests
- Images may need to be taken of your internal bodily structures by ultrasound or doppler analysis
- Magnetic resonance imaging (MRI)
- Your heart activity may need to be tested with an electrocardiogram (ECG, EKG)
The following procedures are offered at St. Elizabeth's Interventional Peripheral Vascular Lab for the treatment of peripheral arterial disease depending on a patient’s diagnosis:
- Catheter-based revascularization procedures for the treatment of acute limb ischemia, claudication, gangrene / limb salvage and ulcerative disease. These procedures involve a thin tube called a catheter, which is inserted into an artery. These procedures include:
- Balloon angioplasty. A balloon-tipped catheter is used to press plaque against the wall of the artery. This increases the amount of space for the blood to flow.
- Stenting. Usually done after angioplasty. A wire mesh tube is placed in a damaged artery. It will support the wall of the artery and keep it open.
- Atherectomy. Instruments are inserted via catheter. They are used to cut away and remove plaque so that blood can flow more easily.
- Catheter-based embolectomy, thrombectomy, thrombolysis for the treatment of acute limb ischemia. A series of terms used to describe the catheter-based removal of blood clots from vessels in either arteries or veins. The procedure(s) involve placing a catheter near or in the blood clot and actively removing it with suction/aspiration.
- Pedal entry/collateral loop revascularization for the treatment of gangrene / limb salvage and ulcerative disease. This procedure is used when the entry point for revascularization of the blockage in the artery is done distally (away from the obstruction) and work is completed from below. Many times, the blockages on the back end of the obstruction are generally softer, which allows for an easier crossing of the blockage. Once the blockage is safely crossed, then an angioplasty (dilation of the artery) is performed from this location.
To help reduce your chances of getting PAD, make the following lifestyle changes:
- Smoking cessation
- Diabetes control
- Blood pressure control
- Increased physical activity such as a walking program
- Weight loss, if overweight
- Low-saturated fat, low-cholesterol diet
- Foot care, which is very important for people with diabetes:
- Wear shoes that fit properly
- Proper treatment of all foot injuries as healing is slowed when circulation is poor, so the risk of infection is higher