If you've been diagnosed with Peripheral Artery Disease (PAD), you're probably feeling anxious and worried that you didn't entirely take in everything that your doctor told you. Don't worry. In this article, we'll discuss everything you need to know to set your mind at ease.
What is Peripheral Artery Disease?
PAD is a progressive condition commonly suffered by older adults and occurs when the blood flow to the arteries gradually becomes more restricted. The disease can lead to serious issues ranging from legs cramps to pain in the legs when walking to wounds that won't heal. In some advanced conditions, it may be necessary to amputate a limb.
PAD is also linked to an increased risk of life-threatening conditions, including heart failure and stroke. To avoid these complications, early diagnosis and treatment are essential.
Who does PAD affect?
Approximately 6.5 million Americans over the age of 40 and Hispanics have a slightly higher risk of PAD.
In most cases, the prominent cause is the build-up of plaque or fatty acids along the inner walls of the arteries, which causes the arteries to narrow, impacting blood flow. While PAD usually occurs in leg arteries, it can occur in arteries in any part of the body.
Risk factors for PAD include:
- High cholesterol or high blood pressure
- Smoking – increases risk by 2.5 times
- Diabetes – increases risk by 2.4 times
Furthermore, obesity and a sedentary lifestyle contribute to the development of PAD and, if a family member has PAD, it's pretty likely that you will develop it too.
How is PAD diagnosed?
Because PAD is a silent disease and over half of all patients do not display any symptoms, it's a hard one to diagnose. When patients do have symptoms, the most common is intermittent claudication, otherwise known as cramp, ache, pain, numbness or a sense of fatigue in the muscles. These symptoms occur during exercise and ease with rest.
As PAD is commonly non-symptomatic, routine screening tests are helpful. For anyone over the age of 50 with one or more risk factors for PAD, a comprehensive vascular physical exam will help identify the early signs of arterial blood flow reduction.
The examination procedures are gentle, non-invasive and straightforward, so there's no need to worry. They include:
- checking blood pressure and pulses in the legs and feet
- observing the colour and skin temperature of the legs and feet
- listening for tell-tale signs of turbulent blood flow
- looking for signs of muscle weakness, hair loss, sores and other changes
If a physical exam shows possible PAD, further testing with a CT scan, ultrasound, or arteriogram (injecting dye into an artery) will be carried out to identify the location and extent of the problem.
How is PAD treated?
Doctors can adopt a conservative approach in its early stages by addressing the factors causing and contributing to the condition. Typically this means lowering high cholesterol with a healthy diet and medication, prescribing low dose aspirin or blood-thinning medication, and quitting smoking tobacco products. A doctor may also implement a supervised walking program to improve a patient's strength and circulation.
Advanced PAD can be treated using a non-invasive procedure – atherectomy. The patient is administered local anesthesia to numb any discomfort, and a catheter is carefully inserted into the affected artery. An instrument attached to the end of the catheter grinds away the plaque, widening the artery and restoring normal blood flow. During the procedure, the pieces of plaque are placed into a holding chamber and removed along with the catheter. In some instances. Atherectomy is combined with an angioplasty procedure that uses a balloon to enlarge the artery.
A long-term study that followed diabetic patients for 2 years found that combining the two procedures was considerably more effective than using the balloon procedure on its own. Not only did it result in better flow, but there was less need for any further intervention and fewer adverse effects.
Atherectomy is performed as an outpatient treatment, meaning there is little downtime, fast healing, and patients can return home the same day. 60 patients with advanced occlusion of a significant leg artery took part in a small clinical trial, and all of them experienced moderate to marked improvement immediately after the procedure.
The Midwest Institute for Non-Surgical Therapy (MINT) offers comprehensive outpatient services for diseases of the veins and arteries and for health conditions that improve with vascular treatment.
Led by Dr Akinwande, the team are passionate about providing the most advanced, evidence-based medicine to all patients.
Why not schedule an appointment using our online service at one of our locations at one of our 5 clinics, including the latest addition in Chicago, IL, to see how we can best help you.