Peripheral Arterial Disease

In the past few years there has been an increase of awareness of Peripheral Arterial Disease, also known as PAD, but what exactly is PAD? How does it affect the lower extremities? And how can it be prevented and treated?

What is PAD?

PAD, which is sometimes referred to as PVD, Peripheral Vascular Disease, is a blockage in the arteries of the legs and pelvis. The most common symptom is pain in the legs while walking, this pain usually resolved at rest. This is an ambiguous symptom and many times can go undiagnosed for a while. If the disease worsens and is untreated it can lead to cold blue feet, wounds, gangrene, and even amputations.

How do I get PAD?

People who are at high risk include smokers, diabetics, people with high cholesterol and high blood pressure.  In addition, men over 50, who are obese, have had a heart attack or a stroke are at higher risk. Smoking is the number one factor that can be altered in order to decrease the risk of getting PAD.

How do I get diagnosed and how is it treated?

If you are concerned that you have PAD, share your symptoms with you physician. Even if the symptoms don’t fit the exact criteria of PAD it does not mean you don’t have PAD. The symptoms can vary and can be vague. Your physician will begin by ordering a test called an ABI/PVR. This is a painless test, where blood pressure cuffs are placed on the arms and legs and measurements are taken. Based on the results you can be diagnosed with PAD. Other tests can be performed, including an ultrasound, angiography, CT or MRI scan.

The sooner treatment is sought the better the long term outcomes. Quitting smoking, controlling diabetes, high blood pressure and high cholesterol are of essence. In addition, exercise is important to increase blood flow to the legs. If these methods are unsuccessful a vascular surgery consultation is the next step in treatment. There are many different methods and techniques where a vascular surgeon can open up the compressed blood vessels. Different balloons and/or stents can be utilized, but will be determined by the degree of the disease, the patient and many other factors. If the disease is to a point where there is gangrene, then usually an amputation is required. An ulceration caused by PAD is treated by aggressive wound care, but more importantly by increase the blood flow to the area of the wound.

In conclusion, if you have mild symptoms or severe symptoms the earlier treatment is sought the better long term outcomes.