Peripheral Artery Disease

PAD Treatment and Diagnosis: What You Should Know

When you think of blocked arteries, it’s likely that the heart comes to mind.  But, while these arteries are vitally important, the heart only represents one portion of the body where arterial hardening and blockages may occur.  In patients with peripheral artery disease (PAD), hardening of arteries occurs outside of the heart, most commonly in the legs.  And, just as clogged arteries in the heart raise the risk of suffering a cardiovascular event, so does PAD.  

What Causes PAD?

PAD is most commonly the result of atherosclerosis, a condition in which plaque builds within the arteries.  Over time, this plaque hardens and reduces the flow of oxygen-rich blood.  Untreated, complications from PAD can include heart attack, stroke, or loss of limbs due to infection or injury.

While the exact cause of atherosclerosis is not known, certain conditions known to damage the inner layers of arteries may be contributors.  These can include smoking, high levels of LDL cholesterol, diabetes, or high blood pressure.

How is PAD Diagnosed?

PAD can be difficult to diagnose, as many patients have no symptoms or symptoms so mild that they give them little consideration.  Of the symptoms that are noted, some of the more common include:

Calf pain or cramping while mobile that improves immediately with rest
Pins and needles at the bottom of the foot that disappears while walking
Open wounds or ulcers on the bottom of the foot that do not heal
Coldness of one lower leg and foot compared to the other
Slow toenail and leg hair growth

In addition to any physical symptoms, physicians may suspect PAD due to family and medical histories or observations from a physical examination.  Confirmation of a PAD diagnosis may be made through:

Ankle-Brachial Index (ABI) – Comparing blood pressure in the ankle to blood pressure in the arm
Ultrasound
Angiography – Injection of a contrast dye into the blood vessels in order to observe blood flow

How is PAD Treated?              

The best possible outcome of PAD depends on timely diagnosis and treatment.  If left untreated, PAD can reduce mobility, lead to amputation, or even death.  Traditionally, patients have been treated with medication regimens to address contributing conditions such as diabetes, blood pressure, or cholesterol and to reduce the possibility of blood clots.  In more advanced cases, surgical intervention using angioplasty or bypass may be required.

Fortunately, advancements have recently led to FDA approval of a new, minimally invasive technique to remove plaque and improve blood flow.  Just over one year ago, Cardiovascular Institute of the South became one of the first in the nation to perform this new procedure, using Avinger’s Pantheris™ lumivascular atherectomy system.  Through this new technique, cardiologists can simultaneously see and remove plaque from the arteries, increasing precision and patient safety while reducing risk and potential arterial damage.  Furthermore, patients treated with this technique may have a reduced need for stents or follow-up procedures.

If your symptoms or medical history indicate a possibility of PAD, speak to an experienced cardiologist about your concerns.  If testing confirms the condition, a plan of care can be developed and non-invasive treatment methods may be available to help reduce the impact of the disease on your life and health.