Peripheral Artery Disease

Peripheral artery disease occurs when the blood vessels outside of the heart develop a build-up of fat and cholesterol and the artery becomes narrower, which restricts blood flow to the body’s tissues.

Due to the buildup of plaque in your arteries, having peripheral artery disease puts you at a greater risk for heart attack or stroke.

Symptoms of peripheral artery disease are typically pain or cramping in the legs and calves during activity. Other symptoms may include: 

  • Leg numbness or weakness
  • Coldness in your lower leg or foot
  • Sores or ulcers on your legs, feet or toes that won’t heal
  • A change in the color of your legs or shiny skin or hair loss on your legs
  • Slower growth of your toenails
  • A weak or no pulse in your legs or feet
  • Erectile dysfunction in men

Women may not experience symptoms as early as men and may not experience pain in the legs during activity.

Peripheral Artery Disease Risk Factors

If you or a loved one have two or more of the risk factors below, register for a free vascular screening.

  • Age of 60 or older
  • Diabetes
  • High blood pressure
  • History of smoking
  • High cholesterol
  • Family history of atherosclerosis (buildup of fat in the artery walls)

Treatments We Provide

There are many ways our vascular team can work to slow or stop progression of peripheral vascular disease. There are medicines that can help. Our accomplished vascular team combines experience and advanced technologies to achieve clinical excellence, from testing and diagnosis to treatment and rehabilitation. We may discuss a medical plan for things you can do at home. Without treatment, peripheral vascular disease can lead to foot or leg amputation or even premature death.

Percutaneous Coronary Intervention (Angioplasty/Stent Placement)
An angioplasty is a less invasive procedure that opens a clogged artery with a small balloon. This can be done through the wrist (radial) or the groin (femoral) artery. Typically this procedure includes the placement of stents.

Bypass Surgery
This surgery creates a bypass graft using a healthy blood vessel from another part of the body or a synthetic tube to reroute blood flow.

Carotid Endarectomy
This surgery removes plaque and clots from the carotid arteries.

Laser Ablation
This minimally-invasive procedure uses a laser to precisely target and clear blood vessel blockages.

Radiofrequency Ablation
This minimally-invasive procedure uses radio waves to heat and destroy the tissue surrounding the area of the vein.

Thrombolytic Treatment
These medicines dissolve and soften plaque and blood clots in blood vessels.

Cardiac Rehabilitation
Spectrum Health offers the area’s largest and most comprehensive cardiac rehabilitation program for patients who have recently experienced a major cardiovascular episode or treatment.

Limb Care and Preservation Clinic
The Limb Care and Preservation Clinic focuses on wound healing, vascular and endovascular therapy, and podiatric surgery. Our goal is to preserve as much function in limbs as possible.

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What Is Peripheral Arterial Disease (PAD)?

Peripheral arterial disease (PAD) refers to blockage of leg arteries by atherosclerosis (hardening of the arteries), so legs have poor blood flow. In atherosclerosis, cholesterol plaques block arteries. PAD occurs in men and women equally. It likely affects 8 to 10 million people in the United States.

What Causes PAD?

Fatty deposits build up inside arteries and make them narrower. Tobacco, diabetes, cholesterol, and high blood pressure make PAD likely. PAD isn’t contagious or passed from parents to children.

What Are the Symptoms of PAD?

About half of people don’t have symptoms. The most common symptoms are pain, cramping, aching, and numbness in the affected area. Others are heavy or tight feeling, cold skin, pale or bluish skin, pulse that’s hard to feel, and sores or ulcers that don’t heal. Aching or cramping leg pain often occurs during exercise and goes away during rest (intermittent claudication). If blood flow is completely blocked, the leg gets very painful and hard to move. In men, impotence can occur if vessels leading to the penis are affected.

How Is PAD Diagnosed?

The health care provider makes a preliminary diagnosis from your symptoms, a physical examination, fasting blood tests, and by measuring the ankle-brachial index (ABI). The health care provider gets the ABI by dividing the highest ankle blood pressure by the highest arm blood pressure. ABI values less than 1 are abnormal.

A treadmill test, Doppler ultrasound, angiography (a kind of x-ray with dye), and magnetic resonance angiography (MRA) may also be done to evaluate the extent of the disorder and areas of blockage.

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How Is PAD Treated?

Treatment goals are to reduce pain and prevent damage to the affected area. Measures include avoiding tobacco, eating a healthy diet, and restricting salt. Diabetics should follow the American Diabetes Association (ADA) diet. Exercise such as walking 30 to 60 minutes per day helps walking distance and quality of life.

Medicines can help blood flow, thin blood, dissolve clots, lower blood pressure, and lower cholesterol levels.

The health care provider may suggest angioplasty for a severely narrowed vessel. The health care provider puts a wire (catheter) into the artery and inflates a tiny balloon to open the blocked artery. The health care provider may put a small metal or mesh tube (stent) into the vessel to keep it open.

People sometimes need bypass surgery to get around the blockage. A procedure called percutaneous atherectomy can also be performed to remove the blockage by inserting a “plaque-eating” device in the blocked artery and shaving off the plaque. In the most advanced stages, PAD may lead to amputation.

DOs and DON’Ts in Managing PAD:
  • DO understand that lifestyle changes for cholesterol, diabetes, hypertension, and tobacco are critical.
  • DO eat a healthy diet, with less fat, especially saturated fat, and less salt. Eat plenty of fruits, vegetables, and wholegrain cereals.
  • DO lose weight.
  • DO get active. Walk for 20 to 30 minutes daily.
  • DO take extra care with controlling your blood sugar if you have diabetes.
  • DO take care of your feet. Examine them regularly, and avoid getting cuts or blisters. Call your health care provider if you have a foot ulcer that doesn’t heal.
  • DON’T smoke. Smoking is the biggest single risk factor for PAD and a major risk factor for heart attack and stroke.
FOR MORE INFORMATION

Contact the following sources:

  • The National Heart, Lung, and Blood Institute
    Tel: (301) 592-8573
    Website: http://www.nhlbi.nih.gov
  • American Heart Association
    Tel: (800) 242-8721
    Website: http://www.americanheart.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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