Peripheral arterial disease (PAD) is most often seen in individuals who smoke, have diabetes, high blood pressure, high cholesterol, a strong family history of coronary disease, or a combination of these risk factors.
PAD is the progressive buildup of plaque in the arteries outside your heart, usually in your legs. The earliest and most common symptom is an ache or cramp in your legs when you walk, that is relieved when you stop walking. As PAD progresses, so does the inability to walk even short distances without having to stop frequently.
The arteries can eventually become clogged with plaque and the blood flow so restricted, that your foot doesn’t get enough oxygen to meet its basic needs to remain viable. In this advanced state of disease, Vascular surgeons describe this as a “limb threat” stage. You may experience “rest pain” in the foot which is noted to be worse at night when you lay flat, and may subside when you hang your feet off the bed. One may also notice discoloration of the foot or a non-healing sore. If steps aren’t taken to intervene, there’s a high risk of limb amputation.
Fortunately, the progression of PAD can be slowed or stopped with lifestyle changes, medication, or a combination of both. Being physically active, especially a walking program, can increase blood flow to the affected leg. For smokers, the most important intervention is to stop smoking immediately. Strict glucose control in diabetics and eating a low-cholesterol, low-fat diet, can also help reduce the buildup of plaque in your arteries. Medications to lower your cholesterol and blood pressure and control your diabetes are also a part of your PAD treatment.
For patients whose PAD has advanced to the stage that it is disabling your ability to work, enjoy your favorite activities, or threatening your limb, circulation may be restored by opening the blockage with a minimally invasive procedure. This outpatient endovascular procedure is performed through a catheter that can open a blocked artery and restore circulation to the leg and foot. If a long section of an artery is blocked, bypass surgery may be needed.
PAD treatments are not “cures”, but can provide a very durable result especially in patients who have minimized the risk factors listed above and embraced a more active lifestyle and healthier diet.
PAD is often a gateway indicator to your overall cardiovascular health. The same healthy choices that decrease your chance of heart disease, also lower your risk of developing peripheral arterial disease. If you’re at risk of PAD, a simple screening test now, can help you identify and prevent problems with your legs later. The most common screening tool is called the ankle-brachial index (ABI). An ABI compares blood pressure in your ankles to the pressure in your arms. This measurement shows how well blood is flowing to your legs and can help identify circulation problems in those blood vessels. This noninvasive, painless test can be performed in less than 30 minutes at the Premier Vascular Access Center.
If you are experiencing leg pains when walking and have foot or leg sores that won’t heal, talk to your physician about being screened for PAD. Or, visit www.premiervascularpad.com for a screening appointment at our outpatient center.
About Dr. Young:
Dr. Richard M. Young, MD, FACS, is a vascular surgeon with the Premier Surgical Associates office located at Fort Sanders Regional Medical Center. He is board certified in vascular surgery by the American Board of Surgery and a Fellow of the American College of Surgeons.
About Premier Surgical Associates
Premier Surgical Associates is the Knoxville area’s largest surgical group, with 26 surgeons performing general, vascular, bariatric, breast and laparoscopic procedures. Premier has offices in Knoxville, Maryville, Jefferson City, Lenoir City and Seymour.