What is peripheral arterial disease?
Peripheral arterial disease (PAD) is a type of atherosclerosis in your peripheral arteries. Your peripheral arteries are the vessels that carry oxygen-rich blood from your heart to your limbs. When your arteries narrow, harden, or clog, the blood can’t reach your limbs to nourish them, causing symptoms such as:
- Claudication (i.e., hip or leg pain brought on by walking or climbing stairs)
- Numb or weak legs
- One lower leg or foot colder than the other
- Shiny or discolored skin
- Slower growth of leg hair or toenails
- Weak or no pulse in legs or feet
- Sores on feet or legs that don’t heal
Men with PAD may also have erectile dysfunction (ED).
What are the risk factors for PAD?
You’re more likely to develop PAD if you have diabetes or if you’re a smoker. Both diabetes and smoking restrict your circulation. Other risk factors are:
- Age over 70
- High blood pressure
- Obesity (BMI more than 30)
- High cholesterol levels
- High levels of homocysteine
You’re also more likely to develop PAD if you’re African American or if you have a family history of PAD. If you have diabetes or other risk factors, you should pay special attention to your feet and contact your Douglas Vascular Center specialist if you notice suspicious changes.
How do doctors diagnose PAD?
At Douglas Vascular Center, the arterial experts pride themselves on their unique protocols that keep a patient’s kidneys safe while determining the extent and severity of their PAD. They use duplex ultrasound to determine the location and extent of arterial disease before even planning an arteriogram. When performing an arteriogram (i.e., arterial X-rays) on very elderly patients or on patients with evidence of kidney damage, patients receive ischemic preconditioning, a technique that stimulates the body’s protective mechanisms for the kidneys. Just prior to your procedure, your doctor inflates a blood pressure cuff on your arm that forces your muscles and tissues to release substances that protect your kidneys from being damaged by the X-ray contrast dye. If you already have significant kidney damage, but don’t need dialysis, Douglas Vascular will perform most of your procedure using injections of medical grade carbon dioxide, a contrast agent which doesn’t hurt the kidneys at all.
In many cases, evaluation of the arteries and veins is more accurately made using intravascular ultrasound (IVUS). IVUS is a catheter-based imaging system used to size blood vessels and to plan therapy, which requires no contrast or X-rays, reducing both radiation exposure and kidney toxicity.
How do doctors treat PAD?
The experts at Douglas Vascular Center also use lifestyle changes, medications, some supplements, and minimally invasive therapies to treat PAD and keep your legs and feet healthy. They may recommend:
- A graded exercise program — walking to the point of discomfort can help your body grow its own bypass vessels, avoiding invasive treatment
- Statins and antiplatelet medicines — even if you don’t have elevated cholesterol levels, the statin drugs have been shown to keep blood vessels open longer. Even more importantly, they can keep you living longer!
- Genetic testing — if you were born with deficiencies in your clotting system, or have high levels of certain amino acids, you may benefit from vitamins or other supplements targeted to your specific deficiency
- Angioplasty and stenting — widening artery with a balloon, then placing a stent, although we emphasize avoiding stents below the waist level if possible
- Atherectomy — breaking up and removing atherosclerosis (the hardening in the artery) with a catheter. This can be particularly effective in removing blockages that may have accumulated in previously placed stents, plus it helps to avoid stent placement in many cases
- Limb salvage — widening vessels and removing plaque to avoid amputation
The expert vascular surgery team reaches your blocked or narrowed arteries through the groin, an arm artery, or through a foot artery, depending on what is safest and most effective for you. They pride themselves on their extremely low rate of complications.
Don’t live with the pain or risk of untreated PAD. Improve your circulation and limb health by contacting the vascular experts at Douglas Vascular Center by phone or use the online form.
