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Peripheral Arterial Disease

Peripheral arterial disease (PAD) is disease of any blood vessel that is not part of the heart or brain. Peripheral arterial disease (PAD) is caused by fatty deposits that can build up in the walls of the arteries (atherosclerosis). PAD is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs, usually the legs.

Causes

PAD is usually caused by atherosclerosis. Other causes include blood clots or embolisms, congenital heart disease and inflammation of the blood vessels called vasculitis.

Atherosclerosis

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PAD can be hereditary. You also may get PAD if you are overweight or obese, have high blood pressure, diabetes, or high cholesterol . Unhealthy lifestyle choices such as smoking, eating a high-fat diet and not getting enough exercise lead to PAD.

Risk Factors

  • Diabetes
  • Cigarette smoking
  • High blood pressure or family history of high blood pressure
  • Stroke or family history of stroke
  • High cholesterol or family history of high cholesterol
  • Age 50 or over
  • High homocysteine level in blood
  • Gender: Male
  • Family history of PAD

Symptoms

Symptoms of PAD are related to the organ or part of the body deprived of blood. This includes:

  • Pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s) brought on by exercise that goes away when resting
  • Numbness and pain of the legs or feet at rest
  • Cold hands, legs or feet
  • Loss of hair on the legs and/or feet
  • Paleness or blueness of the legs
  • Weak or absent pulse in the leg
  • Sores, ulcer, or infection of the feet and legs that heal slowly
  • Erectile dysfunction
  • Swelling in lower extremities
  • Muscle atrophy

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. During the exam, your doctor may:

  • Check the strength of the pulse in the leg arteries
  • Listen for a whooshing sound in a leg artery or the abdomen using a stethoscope
  • Check blood pressure at various points in the leg and compare it to the normal arm blood pressure
  • Conduct a treadmill test
  • Your bodily fluids may be tested and this can be done with blood tests
  • Images may need to be taken of your internal bodily structures by ultrasound or doppler analysis
  • Angiography
  • Magnetic resonance imaging (MRI)
  • Your heart activity may need to be tested with an electrocardiogram (ECG, EKG)

Treatments Offered at the Center for Vascular and Endovascular Surgery

The following procedures are offered for the treatment of peripheral arterial disease depending on a patient’s diagnosis:

  • Endovascular Treatments. PAD can be treated through the following less invasive procedures:
    • Arteriogram – are specialized X-ray studies that are frequently done to check for blockages or narrowing in the blood vessels. Sometimes it is possible to treat a blockage found within an artery during an arteriogram.
    • Balloon angioplasty– a balloon is inflated in the artery to stretch it.
    • Stent implant – a wire mesh tube is placed in the artery; the stent expands and stays in place, keeping the artery open.
  • Lower Extremity Bypass. During a lower extremity bypass surgery a detour is created around a narrowed, or blocked, section of a leg artery. To create this new path for the blood to flow to the leg tissues, a vein from another part of the body or a synthetic graft replaces the vessel.

Prevention

To help reduce your chances of getting PAD, make the following lifestyle changes:

  • Smoking cessation
  • Diabetes control
  • Blood pressure control
  • Increased physical activity such as a walking program
  • Weight loss, if overweight
  • Low-saturated fat, low-cholesterol diet
  • Foot care, which is very important for people with diabetes:
    • Wear shoes that fit properly
    • Proper treatment of all foot injuries as healing is slowed when circulation is poor, so the risk of infection is higher

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Conditions and Treatments

Vascular disease comes in many different forms and our world class surgeons are experts at diagnosing and treating a wide-spectrum of vascular diseases

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Many patients who come to the Center for Vascular and Endovascular Surgery at St. Elizabeth's have a story to share about their care, recovery, and success after surgery or other treatments.

Contact Us

Center for Vascular and Endovascular Surgery
St. Elizabeth's Medical Center
736 Cambridge Street
Brighton, MA 02135
617-779-6504

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