What is Peripheral Artery Disease?
Peripheral Artery Disease (PAD) occurs when the peripheral arteries narrow
or are blocked by plaque, or atherosclerosis. Most commonly, PAD involves
the leg arteries. Though PAD affects about 10 million people in the United
States, many people don't know they have the disease. That's because
in its early stages, PAD may not cause any symptoms or unusual symptoms
and it goes unrecognized. Later in the disease, PAD can lead to cramping,
leg pain, and even the loss of a leg or increased risk for heart disease
or carotid artery disease.
Atherosclerosis, or hardening of the arteries, is the disease which causes
PAD. It also causes other circulatory disorders, including heart disease,
carotid artery disease and aneurysms. Essentially, atherosclerosis is
the buildup of plaque on the inside of your artery walls. This buildup
can cause your arteries to narrow, reducing blood flow significantly.
Many people assume that pain when walking is a normal part of aging, but
it is not. Some studies suggest that women may not experience the same
symptoms of PAD as men, or may not experience them as early as men. This
can put women at greater risk for complications associated with later-stage
Symptoms of PAD often include:
- Pain or cramping in the legs while walking or exercising that eases when
you are at rest.
- A tired or heavy feeling in your legs.
- Swelling or numbness in your legs.
- Foot or toe pain at rest that often disturbs your sleep.
- Skin discoloration.
- Cold feet or legs.
- Ulcers or sores that won't heal on the lower legs or feet.
If you are experiencing any of these PAD symptoms, you should consult your
doctor or schedule an appointment to see one of the board-certified cardiologists
at Providence Medical Center and Saint John Hospital.
Risk factors for PAD include:
- Over age 50.
- Family or personal history of heart disease or stroke.
- High blood pressure.
- High cholesterol.
- Overweight or an inactive lifestyle.
To diagnose PAD, a physician usually begins with a medical history and
physical exam. In the exam, a simple test called the ABI (ankle brachial
index) is performed. If that indicates a possible problem, other tests
may be done. They include:
- Doppler and duplex ultrasound imaging.
- Magnetic resonance angiogram (MRA).
- CT angiogram.
- Regular (catheter-based) angiogram.
Most people with PAD can be treated with lifestyle changes, medicines or
both. Lifestyle changes to lower your risk for PAD include:
- Stop smoking. (Smokers are two to 25 times more likely to get PAD and experience
symptoms of PAD 10 years earlier than nonsmokers.)
- Control diabetes.
- Control blood pressure.
- Be physically active (including a supervised exercise program).
- Eat a low-saturated-fat, low-cholesterol diet. PAD may require drug treatment,
which includes medicines to help improve walking distance, keep platelets
from sticking together and cholesterol-lowering agents.
When these lifestyle changes and medications aren't enough, an intervention
may be necessary. Providence Medical Center offers a variety of state-of-the-art
interventions for PAD that can be expertly used to open difficult-to-treat
blockages with a high degree of success. Some of these devices include:
Avinger Wildcat Catheter--Providence was the first hospital in the Kansas City area, and the first
in the state of Kansas, to use this FDA-approved catheter to open chronic
Stealth 360—This orbital atherectomy system is ideal for sanding away hardened
or calcified plaque and restoring blood flow to the peripheral arteries.
TurboHawk Directional Atherectomy—This atherectomy system is used in the peripheral arteries to shave
off highly-calcified plaque and remove it.
In addition, Providence specialists use angioplasty and stents to treat
PAD. An angioplasty is a non-surgical procedure that widens narrowed or
blocked arteries. A thin tube called a catheter with a deflated balloon
on its tip is passed into the patient's narrowed artery. When the
balloon is inflated, it pushes the narrowed area open. When the balloon
is deflated, the catheter is withdrawn.
Doctors also often use a stent — a wire mesh tube — which is
placed in the narrowed artery with a catheter. There the stent expands
and locks open. It stays in that spot, keeping the diseased artery open.
If a long part of an artery is narrowed, surgery may be needed. A vein
from another part of the body or a synthetic blood vessel is attached
above and below the blocked area to detour blood around the blocked spot.
To learn more about your treatment options for PAD, talk with your physician
or schedule an appointment with one of the board-certified cardiologists, call the
Cardiac Care Center at