By SUMAN ANNAMBHOTLA, M.D.
Vascular & Vein Specialists at The Longstreet Clinic, P.C.
It would be hard to find many people who don’t know that we’re in the midst of Breast Cancer Awareness Month, an important tool to encourage the early detection of breast cancer.
However, most of those same people probably didn’t know that last month, September, marked Peripheral Arterial Disease Awareness Month. You may even be asking, “What is Peripheral Arterial Disease and why do I need to be aware of it?”
PAD is the most common type of Peripheral Vascular Disease, which refers to any disease of the blood vessels outside of the heart and brain. PAD most often is caused by a hardening or narrowing leading to blockage of the arteries in the legs associated with cholesterol deposits, also known as arteriosclerosis. This narrowing restricts blood flow which can damage nerves and tissue in the legs and feet.
If left untreated, PAD can result in pain, wounds, gangrene and amputation. Patients also are at a higher risk for stroke and heart attack. This is why it’s so important to be aware of the disease’s signs.
There are a variety of symptoms associated with the disease which usually starts with pain and discomfort in the calves or legs when walking that is only relieved by rest. This is called claudication. Over time, this fatigue occurs more quickly and with less and less exertion. Other symptoms of PAD include hip and thigh pain, legs that feel cool to the touch, non-healing wounds, as well as erectile dysfunction.
Those who smoke and have diabetes are at a very high risk of PAD. Even those who do not show any symptoms of PAD, but smoke and/or have diabetes should be tested for the disease. The best way to lower the risk of PAD is to stop smoking, lose weight and gain control of high blood pressure and cholesterol. Your doctor will be able to talk to you about the specifics of what you should do to lower your risk.
When further treatment of PAD is necessary, your physician may refer you to a vascular surgeon. If symptoms have become severe, medication or surgery may be necessary. Balloon angioplasty and stent placement are two common minimally invasive procedures designed to open blocked arteries and restore circulation back to the legs.
The balloon angioplasty procedure is performed to help open blocked arteries by expanding the inner diameter with a balloon mounted on a thin tube. Cardiologists will perform this same procedure in the coronary arteries around the heart while vascular interventionalists perform this procedure in vessels outside the heart.Stents are used to help hold arteries open as an adjunct to balloon angioplasty.
In some circumstances, balloon angioplasty and stenting may not be successful or may not be an option. This can occur if the blockage in the artery is too long or diseased. In that situation, vascular surgeons can perform open extremity bypass surgery. This involves using a segment of vein from the leg or arm, or using a graft (plastic tube) to create a new avenue for the blood to flow to the lower leg. This can be a robust and successful long term solution and can alleviate many of the symptoms described above.
At Vascular & Vein Specialists at The Longstreet Clinic, we are able to screen for Peripheral Vascular Disease, including PAD, in our ICAVL-certified vascular lab. We also are able to offer onsite treatment through our Vascular Access Center, which allows our surgeons to perform a variety of procedures in an outpatient setting where patients can go home the same day.
According to the American Heart Association, Peripheral Artery Disease affects approximately 8 million Americans, as many as 1 in 5 Americans age 65 and older. Many cases also go undiagnosed because people do not understand what their symptoms mean or they have no symptoms.
We encourage you to learn more about PAD and the lifestyle changes you can make to potentially prevent it, as well as the disease’s signs and symptoms so that if necessary, you or a loved one can receive appropriate treatment.