Thursday, February 10, 2011

Peripheral Artery Disease

Peripheral Artery Disease (PAD)

Peripheral artery disease, or PAD, affects 8-12 million Americans. 8 million of those will never experience symptoms. Even without symptoms, people with PAD are at a higher risk of heart attack and stroke. Early diagnosis and treatment can reduce the risks and relieve symptoms of PAD.
PAD is the most common type of peripheral venous disease (PVD), and is characterized by fatty deposits, called plaque, on the inside walls of arteries. The medical term for this is atherosclerosis, but you may have heard it referred to as "hardening of the arteries". This can cause a restriction in blood flow to the arms, kidneys, and stomach, but most commonly the legs and feet.
athero- means deposit, sclerosis means hard doctors are experienced at diagnosing PAD.  If you have any symptoms of PAD or any risk factors for PAD, please make an appointment to have our doctors examine you. Most people with PAD experience no symptoms, but are still at greatly increased risk for heart attack and stroke. Early diagnosis and treatment is important.
If you do have PAD, we can perform several minimally invasive outpatient procedures that can reduce blockages in your arteries and allow you to return to an active life. Angioplasty is used to open up blood vessels that are narrowed by plaque, allowing the blood to flow freely. We also do stent placement, in which a small mesh tube may be placed to hold the blood vessel open. If a blood clot forms, thrombectomy or thrombolysis can be used to dissolve or remove the blood clot before it causes further problems. In severe cases of PAD, our procedures can help you avoid amputation of the foot or leg.

Symptoms and Signs

PAD causes a restriction in blood flow to the legs and feet due to plaque buildup in the arteries. When you exercise, your muscles needs more oxygen, and thus they need more blood flow. If the muscles are not provided with the oxygen they need, they can cramp or feel achy or tired. The symptoms of PAD may appear only when you exercise, and subside shortly after you stop. This is called "intermittent claudication", and it is the most common symptom of PAD.


  • pain in legs or buttocks
  • cramping in legs or buttocks
  • fatigue in legs or buttocks
  • numbness in legs
  • numbness in feet
  • symptoms subside a few minutes after you stop exercising


  • legs or feet cooler than other parts of your body
  • non-healing sores on the foot or leg
  • gangrene in sores on your foot or leg
  • low blood pressure in legs and feet

Symptoms are indicators of a disease that you experience, while signs are indicators of a disease that can be seen. Your doctor will ask you about the symptoms you experience and examine you for signs.


PAD can be diagnosed by a physical exam coupled with several painless non-invasive tests. An ankle-brachial index (ABI) test will be performed to check the blood pressure at your ankle. In an adult without PAD, this should show an ankle pressure that is at least 90% of the blood pressure taken on the arm. In an adult with PAD, it may be as little as 50%.
If the ABI test indicates a possible narrowing of the arteries, your doctor may perform one of the following tests to gather more information:
  • Doppler and Ultrasound (Duplex) imaging: a non-invasive method that visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of a blockage.
  • Computed Tomographic Angiography (CT) is a non-invasive test that can show the arteries in your abdomen, pelvis and legs.
  • Magnetic Resonance Angiography (MRA): a non-invasive test that gives information similar to that of a CT without using X-rays.
  • Angiography is the examination of the arteries by using a contrast agent and X-rays to look for blockages in the arteries of the leg. This is generally done during treatment to view the blood flow so it is clear when the blockage has been removed.


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