Peripheral Arterial Disease
Peripheral Arterial Disease (PAD) is a condition in which narrowing of the peripheral arteries can cause limited blood flow to the legs. The most common cause of PADis a plaque or fatty deposit build up in the arteries, also known as atherosclerosis. An estimated 8-12 million people in the United States are at risk for Peripheral Arterial Disease.
Although symptoms may vary from patient to patient, some of the most common symptoms of PAD include pain or discomfort in the legs when walking, tightness, heaviness, and cramping in the legs when going uphill or up a flight of stairs. This condition is called Intermittent Claudication (IC). In patients with more severe PAD, pain in feet or toes when at rest and painful stores on toes, legs, or feet that don’t heal may occur. This condition is called Critical Limb Ischemia (CLI). Patients with CLI may have weak or absent pulses in legs or feet.
Patients at highest risk for PAD are those over age 60, current or past smokers and patients who have high blood pressure, high cholesterol, or diabetes.
Early diagnosis is important in treating PAD. Diagnosing PAD requires a careful history and a physical exam by a physician with additional testing to secure the diagnosis. Additional non-invasive diagnostic tests for PAD include:
- Ankle-brachial index (ABI)
- Segmental limb pressures
- Pulse volume recording (PVR)
- Doppler velocity waveform analysis
- Functional testing (treadmill exercise testing)
- Duplex scanning
Once the diagnosis is confirmed using the above listed non-invasive studies, additional studies such as a CT angiography, MR angiography or catheter-based angiography may be needed to assess the severity of the disease and plan appropriate treatment pathways.
BMC physicians use state of the art therapies to treat PAD. For patients with intermittent claudication who have difficulty walking, the goal is to improve symptoms, walking distance and quality of life. Patients with Critical Limb Ischemia have pain in the feet at rest or sores that do not heal and are at risk of losing their leg if the circulation to their leg is not improved. BMC’s PAD specialists improve the blood flow to the affected leg and do everything possible to avoid amputation.
Treatment options for PAD include:
- Lifestyle Changes – this may include quitting smoking, lowering blood pressure and blood cholesterol, lowering blood glucose levels and becoming physically active.
- Medications – this may include medicines to help lower blood pressure or cholesterol levels, help ease leg pain or help prevent worsening of leg circulation.
- Improving Circulation – if symptoms aren’t controlled through medication, the patient’s physician may recommend improving circulation by minimally invasive or surgical procedures.