Peripheral Artery Disease

Peripheral Artery Disease, commonly referred to as PAD, is a chronic condition of the arteries of the arms and legs. In PAD, the arteries in the arms and legs develop blockages, reducing blood flow to the limbs. They are caused by arterial plaque buildup on the wall of the artery that causes narrowing of the artery. This can result in leg pain, wounds and skin discoloration.

Risk Factors

• Age greater than 70 (50 if you have diabetes or smoke)
• Diabetes
• Smoking
• Hypertension (High Blood Pressure)
• High cholesterol
• Lack of exercise
• Family history of vascular issues
  

Symptoms

• Cramping pain in the legs and calves with walking or exercise, can worsen over time and, in severe disease, be painful while at rest
  
• Cool temperature of skin
  
• Discoloration of toes, gangrene (death of muscles and skin tissue) in severe disease
  
•  Wounds that do not heal over time
  

Diagnosis

• Non-invasive studies
  • Ankle-Brachial Index: a comparison between the blood pressure measurements in your arms and legs
    
  • Pulse volume recordings: A series of blood pressure measurements to help in determining location and severity of disease
    
  • Arterial duplex ultrasound: an ultrasound test to visualize blood flow.
    
  • CTA/MRA: A scan with the use of dye to visualize the blood flow throughout the arteries
    

Treatment

• Conservative Management
  • Programmed walking exercise: Patients who experience claudication symptoms should attempt to increase their exercise tolerance. Patients should attempt at least 30 mins of walking, three times a week
  • Medication
    • Antiplatelet medications like aspirin and Plavix; cholesterol medication that can help decrease the amount of plaque buildup; and vasodilators, like Cilastazol
• Endovascular Revascularization
  • Patients with persistent claudication or non-healing wounds should undergo an angiogram. A surgeon injects dye into the arteries to visualize flow. From there, the surgeon can use arterial balloons, stents and atherectomy devices to attempt to open the arteries and clear the blockages to improve blood flow
• Surgical Procedures
  • For patients who are not candidates for endovascular revascularization, surgery may be required to bypass the blockage or clear the plaque from the artery
    

Learn more

Peripheral Artery Disease (PAD)
Varicose and Spider Veins
Deep Venous Thrombosis (DVT)
Abdominal Aortic Aneurysm (AAA)
Peripheral Aneurysmal Disease
Carotid Artery Disease
Dialysis Access
Wound Care
Vascular Lab
Giant Cell Arteritis
Lymphedema
Mesenteric Ischemia