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Arterial Interventions

Peripheral Vascular Disease (PVD)
PVD can cause a variety of problems in the legs ranging from leg pain to amputation of the leg.  The mildest forms of arterial disease frequently do not produce any symptoms.  As the disease becomes worse, it leads to pain in the muscles of the leg when walking (intermittent claudication). If the disease becomes very severe, more serious problems can develop.  The most worrying symptoms are a continuous pain (rest pain) in the foot, especially at night, black toes, and ulcerations.  When these problems develop the patients are sometimes described as having critical limb ischemia.  This means that the patient has developed problems that are putting the leg at risk of amputation.

Many patients with and without PVD can experience night cramps in the legs.  Although these cramps can be quite severe, they are not caused by hardening of the arteries and are not a risk to the legs.

PADPeripheral Arterial Disease (PAD)
PAD is a common circulation problem in which the arteries that carry blood to the legs or arms become narrowed or clogged.  This interferes with the normal flow of blood, sometimes causing pain, but often causing no symptoms at all.  The most common cause of PAD is atherosclerosis, often called “hardening of the arteries.”  Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, forming a substance called “plaque” that clogs the blood vessels.  In some cases, PAD may be caused by blood clots that lodge in the arteries and restrict blood flow.  Left untreated, this insufficient blood flow will lead to limb amputation in some patients. In atherosclerosis, the blood flow channel narrows from the buildup of plaque, preventing blood from passing through as needed, restricting oxygen and other nutrients from getting to normal tissue.  The arteries also become rigid and less elastic, and are less able to react to tissue demands for changes in blood flow.  Many of the risk factors—high cholesterol, high blood pressure, smoking, and diabetes—may also damage the blood vessel wall, making the blood vessel prone to diffuse plaque deposits.

Prevalence

  • PAD is a disease of the arteries that affects 10 million Americans.
  • PAD can happen to anyone, regardless of age, but is most common in men and women over age 50.
  • PAD affects 12 to 20 percent of Americans age 65 and older.

PAD Symptoms
The most common symptom of PAD is called claudication, which is leg pain that occurs when walking or exercising and disappears when the person stops the activity.  Other symptoms of PAD include: numbness and tingling in the lower legs and feet, coldness in the lower legs and feet, and ulcers or sores on the legs or feet that don’t heal.  Many people simply live with the pain, assuming it is a normal part of aging, rather than reporting it to the doctor.  However, if these symptoms are familiar to you, there are treatment options.

PAD Treatments

Lifestyle
Often PAD can be treated by making changes to your lifestyle.  For example, smoking cessation and a structured exercise program are often all that is needed to alleviate symptoms and prevent further progression of the disease.

Angioplasty and Stenting
Interventional radiologists pioneered angioplasty and stenting, which was first performed to treat peripheral arterial disease.  Using imaging for guidance, the interventional radiologist threads a catheter through the femoral artery in your groin to the blocked artery in your leg.  Then he or she inflates a balloon to open the blood vessel where it is narrowed or blocked.  In some cases the vessel is then held open with a stent, a tiny metal cylinder. This minimally invasive treatment does not require surgery –  just a nick in your skin the size of a pencil tip.

Get Tested For PAD If You:

  • Are over age 50
  • Have a family history of vascular disease, such as PAD, aneurysm, heart attack, or stroke
  • Have high cholesterol and/or high lipid blood test
  • Have diabetes
  • Have ever smoked or smoke now
  • Have an inactive lifestyle
  • Have a personal history of high blood pressure, heart disease, or other vascular disease
  • Have trouble walking that involves cramping or tiredness in the muscle with walking or exercising, which is relieved by resting
  • Have pain in the legs or feet that awakens you at night

Are you at risk for Peripheral Arterial Disease (PAD)?

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