Peripheral Artery Disease
Peripheral artery disease (PAD) occurs when the arteries in the legs become stiff or narrow due to plaque build-up and block the flow of blood and oxygen from the heart. PAD is sometimes called "leg artery disease" and can cause discomfort anywhere in the legs between the hips down to the upper feet when walking. It may even lead to limb loss, heart attack or stroke.
Peripheral artery disease is more likely to develop with age, and the risk increases with the presence of diabetes, obesity, high blood pressure and high cholesterol. Living a healthy lifestyle, with nutrition and exercise and without smoking, is the best way to prevent the onset of PAD.
SymptomsPatients with PAD may not feel any symptoms other than intermittent discomfort in legs that goes away when they stop walking. The discomfort could be tightness, heaviness, cramping or weakness that comes with activity. Advanced PAD may lead to critical limb ischemia, which is pain even when at rest, and in its most severe stages, PAD patients may develop painful sores on their toes and feet that could lead to gangrene.
A routine physical exam which includes listening to the heartbeat, taking blood pressure and asking about medical history may indicate the potential presence of PAD. If a patient falls into a high-risk category, the doctor may take a pulse behind the knees or on the feet. If PAD is suspected, an ankle-brachial index may be performed which compares the blood pressure in the arms and legs, and a cholesterol test may be recommended.
Further testing may be prescribed to better understand the extent of the PAD and your physician may choose from several procedures, including ultrasounds, non-invasive imaging tests (MRA), and CT scans or angiography that use contrast dye to highlight the arteries. Angiography is typically used for patients with more severe PAD.
Treatment at NYM
Treatment depends on the severity of the condition and ranges from lifestyle changes (smoking cessation, exercise) to medications (to lower cholesterol or blood pressure) to surgery.
- Angioplasty and Stenting: a less invasive procedure where a surgeon inserts a long, thin tube called a catheter through a small puncture site in the groin. It is guided through the blood vessels and into the affected artery where it first takes a picture (angiogram) and then another catheter is inserted with a tiny balloon that inflates and deflates, flattening the plaque against the walls of the artery. Finally, a stent is inserted to hold the artery open.
Endarterectomy: A surgeon makes an incision and removes the plaque that has built up inside the inner lining of the artery.
- Bypass: A surgeon creates a detour around a blocked artery, allowing for free passage of blood and oxygen.
- Amputation: a last-resort treatment done in only the most extreme cases of PAD.
For more information on these procedures, talk to one of our surgeons by calling 718.780.3288.
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