Diagnosing and Treating Peripheral Artery Disease
When veins in a person's legs are narrowed or blocked by a buildup of fatty plaque, peripheral artery disease (PAD) may have taken hold. Vascular and Interventional Surgeon Denise A.B. Smith, MD, PhD, RPVI, provides an overview of PAD.
Q: How serious is PAD and who is affected?
When blood vessels become narrowed or blocked, blood flow to the brain and heart is reduced. This puts the patient at risk for a heart attack or stroke. If ignored, PAD can also cause gangrene (tissue death caused by loss of blood supply) or ulcers that don’t heal. These can eventually lead to amputation. The disease affects men and women equally; however, black ethnicity is associated with an increased risk of developing the disease, according to the federal Centers for Disease Control and Prevention.
Q: How do I know if I have it?
Unfortunately, like other vascular diseases, PAD has few early symptoms. As the disease progresses, patients might feel pain in the legs when walking, and then relief when resting. Many people with PAD have no symptoms, according to the American Heart Association. We use the anklebrachial index (ABI) along with an exam to detect PAD. The ABI is a simple, painless test that compares blood pressure in the arm with that in the ankle. A low number can indicate narrowing or blockage of the arteries in the legs.
Q: How is PAD treated?
Sometimes lifestyle changes such as exercise can slow PAD’s progression. Medications are also used to reduce symptoms. For some people, these steps are not enough. In such cases, we remove the clot or open the blocked artery using minimally invasive catheterization procedures. If the blockage is severe or the blood vessel is weakened, we may harvest a vein from another part of the body to bypass the problem area.
Q: How can I keep my blood vessels healthy?
First, if you smoke, stop. Inhaling tobacco smoke is a major risk for PAD, and increases your risk of heart attack and stroke. You should choose a diet that’s low in saturated fats. Your doctor may prescribe medication if diet alone does not lower your blood cholesterol levels. Finally, physical activity can be an effective treatment for PAD. Check with your physician before starting an exercise program.