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Vascular Laboratory
What is Peripheral Artery Disease (PAD)?
PAD
is very common in the arteries of the pelvis legs. It is a narrowing of
the blood vessels to the legs which is caused by a buildup of fatty
plaque. PAD may show up in arteries before there are any signs or
symptoms. The arteries become narrowed and blood flow decreases with PAD.
Warning
Signs
Unfortunately, there are often no symptoms or warning signs for Peripheral
Artery Disease. Research has shown that nearly 75% of people with PAD do
not experience symptoms. Women are less likely to have symptoms than men.
However, you may want to keep the following symptoms in mind:
-
The
most common symptom of PAD is painful cramping in the buttocks, hips,
thighs or calves when walking, climbing stairs or exercising;
-
Constant
leg pain, tingling, burning or loss of sensation.
Many
people dismiss leg pain as a normal sign of aging. You may think it is
arthritis or stiffness from aging. PAD leg pain occurs in the muscles, not
the joints.
IF YOU HAVE ANY KIND OF RECURRING PAIN, SPEAK TO
YOUR HEALTHCARE PROFESSIONAL AND DESCRIBE THE PAIN AS ACCURATELY AS
POSSIBLE.
-
Foot
pain that does not go away when you stop exercising;
-
Foot
or toe wounds that will not heal or heal very slowly;
-
A
marked decrease in the temperature of your lower leg or foot;
-
Gangrene.
Risk
Factors:
There are certain risk factors for PAD which cannot be controlled, such as
aging or having a personal or family history of PAD, cardiovascular
disease or stroke. However, there are many risk factors you can control
including:
-
Cigarette
Smoking
-
Obesity
-
Diabetes
Mellitus
-
High
Blood Pressure
-
High
Blood Cholesterol
-
Lack
of Exercise
Chronic
Kidney Disease
It is important to take care of all risk factors under your control,
develop a heart healthy lifestyle and to cooperate with your healthcare
professionals.
Diagnosis
PAD diagnosis begins with a physician examination. Your doctor will check
for weak pulses in the legs. An ABI, or ankle-brachial index test is
usually done. The exam is painless and compares the blood pressure in your
feet to the pressure in your arms to determine how well the blood is
flowing.
Treatment
Treatment for PAD focuses on reduction of symptoms and prevention of
further progression of the disease. In many cases, lifestyle changes,
exercise and medication are enough to slow the progression of the disease.
Exercise: The most effective treatment for PAD is regular exercise.
Walking is one of the best forms of exercise.
Diet: Many PAD patients have elevated cholesterol levels. A diet
low in saturated fat and cholesterol can help lower blood cholesterol
levels.
Smoking Cessation: Smoking greatly increases your risk for PAD and
your risk of a heart attack and stroke.
Medication: You can speak to your doctor regarding medication
therapy.
Procedures: For some patients diet, exercise and medication may not
be enough. Minimally invasive procedures consist of angioplasty,
atherectomy or stent placement. These are non-surgical procedures where a
needle puncture hole is made through which a catheter is inserted to reach
the blocked artery. A tiny balloon is inflated inside the artery. An
atherectomy may be performed to remove the plaque. A stent, a tiny wire
mesh cylinder, may also be implated at this time to help hold the artery
open.
Please contact your doctor if you have any of the symptoms or risk factors
mentioned here.
Please
click on the following to learn more about the non-evasive examinations we
specialize in based on the symptoms associated with:
Pulse Volume Recording (PVR)
and segmental blood pressure evaluations of the upper and lower
extremities indirectly quantitate the severity of disease through
physiological data analysis. Duplex ultrasound allows assessment of
arterial flow, plaques, and aneurysm or dilated segments. Duplex
ultrasound is also used to evaluate the patency of grafts and
revascularizations. This allows for identification of graft stenosis or
revascularization of native artery stenosis prior to occlusion and in some
cases the identification of stenosis can lead to prophylactic
intervention.
Symptoms for arterial examinations:
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Patients with cramping
in thigh, hip, buttock, or calf while walking relieved by rest
-
Absent pulses
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Numbness or tingling of
the extremity
-
Cold leg
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Ulcers or non healing
wounds (toes and ankles)
A duplex ultrasound of the
upper or lower extremities is an excellent test for the evaluation for
blood clots (DVT) and venous insufficiency. The test is highly accurate
and painless to the patient. Follow up studies serial examinations will
allow for the evaluation of thrombus propogation. Follow up studies are
particularly useful in situations where one does not want to subject the
patient to anticoagulation unless absolutely necessary. Venous
insufficiency can cause unceration. Duplex untrasound can identify the
etiology of this chronic condition thereby allowing appropriate treatment.
Symptoms for DVT:
Venous insufficiency symptoms:
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