Peripheral Arterial Disease

Reducing Complications in Patients With Arterial Blockages

Peripheral Arterial Disease (PAD) or Peripheral Vascular Disease (PVD) is a disease of the peripheral blood vessels characterized by narrowing and hardening of the arteries that supply the legs and feet. The decreased blood flow results in nerve and tissue damage to the extremities.

PAD/PVD is a highly prevalent, under-diagnosed, under-treated disease. PAD/PVD has a gradual onset, initially asymptomatic until secondary complications develop. Surprisingly, 50 percent of people with PAD have no symptoms, while 40 to 50 percent may present atypical, non-specific leg complaints.

Although Peripheral Arterial Disease is serious, it is treatable. Treatment may slow or stop disease progress and reduce the risk of complications. Treatments include lifestyle changes, quitting smoking, medicine, and surgery or procedures.

Reasons for Referral

Leg pain upon activity
Intermittent Claudication
Weak or absent peripheral pulses
Pallor or cyanosis
Peripheral numbness
Cool extremities
Minimal to no hair growth on extremities

Procedures

Doppler Ultrasound

A Doppler ultrasound looks at blood flow in the major arteries and veins in the limbs. During this test, a handheld device is placed on your body and passed back and forth over the affected area. A computer converts sound waves into a picture of blood flow in the arteries and veins. The results of this test can show whether a blood vessel is blocked. The results also can help show the severity of PAD.

Balloon Angioplasty/Stenting

A procedure in which your physician inserts a balloon catheter into a narrowed portion of an artery. Expanding the balloon compresses the plaque against the artery wall and reduces the blockage. The balloon and catheter are then removed. The stretching of the artery greatly improves blood flow through the artery. Often a metal device called a stent is left in the artery to improve the chances that the blood vessel will stay open.

Arteriogram

An arteriogram provides a “road map” of the arteries. Doctors use this test to find the exact location of a blocked artery. For this test, a dye is injected through a needle or catheter (tube) into one of your arteries. This may make you feel mildly flushed. After the dye is injected, an x-ray is taken. The x-ray can show the location, type, and extent of the blockage in the artery.

Percutaneous or Laser Atherectomy

A procedure in which an interventional radiologist inserts a specialized catheter into a blocked artery to remove a buildup of atherosclerotic plaque from within the vessel. The catheter contains a sharp rotating blade, grinding bit, or laser filament, as well as a collection system that permits the surgeon to remove the plaque from the wall of the vessel and collect or suction any resulting debris.

IVUS

Intravascular ultrasound (IVUS) is a newer method of arteriogram that uses tiny ultrasound cameras. These cameras take pictures of the insides of the blood vessels.