Peripheral Artery Disease

MetroSouth Medical Center cardiologists and interventional cardiologists have significant experience and expertise in diagnosing and treating peripheral artery disease.  Peripheral Artery Disease is a circulatory condition in which blood flow to your limbs is limited because of narrowed arteries. Most often, limited blood flow affects the legs, which results in leg pain when walking (intermittent claudication). Peripheral Artery Disease, also known as PAD, can also point to widespread fatty deposits in the arteries (atherosclerosis). This often means that blood flow to the brain and heart also is reduced.  

Symptoms:

• Leg pain while walking
• Ulcers on the legs
• Hip, thigh or calf muscle cramping after walking or climbing stairs
• Leg weakness and numbness
• Changes in toenails
• Loss of hair on legs or feet
• Foot or leg sores that won’t heal
• Coldness in the foot or lower leg

Diagnosing PAD:
Diagnosis of PAD begins with a complete examination and history by a clinician experienced in identifying PAD. Peripheral artery disease is in many cases overlooked with dyer consequences. In fact, patients with PAD who are NOT experiencing symptoms have a higher risk of heart attack, stroke and even death, than a patient with symptoms related to coronary artery disease. Because of this, understanding of the risk factors, and screening patients at risk is critical.

The following patients are at risk for peripheral artery disease:

• African Americans
• Diabetics
• Smokers
• Those with a history of kidney disease
• Elevated cholesterol and triglycerides
• High blood pressure
• Those with atheroclerosis elsewhere in the body (heart, neck, etc.)

Interventional cardiologists at MetroSouth Medical Center recommend that high risk patients are appropriately evaluated and screened. The evaluation starts with a thorough physical examination and history, with specific emphasis on leg or foot pain or coldness, pallor in the legs, and tingling or numbness in the leg or foot. In addition to this examination, the physician may order an Ankle-Brachial Test.

• Ankle-Brachial Test:  Used to diagnose Peripheral Artery Disease, this test measures systolic blood pressure, which is the force that blood exerts on artery walls as the heart contracts. The test involves lying on a table and having a cardiologist measure blood pressure in both arms and four places on the legs. The doctor divides the systolic pressure in the ankle by the systolic pressure in the arm. The result is called the ankle-brachial index (ABI), also called ankle-arm pressure index (API). An ABI over 0.90 rules out Peripheral Artery Disease. The lower the index, the greater the chance for stroke, heart attack other heart conditions.

Treatment:
The first course of treatment for Peripheral Artery Disease is to implement lifestyle changes to reduce the risk of heart attack or stroke. If lifestyle changes aren’t effective, your doctor will prescribe medication to prevent blood clots, reduce pain and lower blood pressure and cholesterol. Surgery is another treatment option. Treatments include:

• Supervised exercise program
• Cessation of smoking (the single most important thing you can do)
• Statins (medications to lower cholesterol)
• Beta blockers or ACE inhibitor medication to lower blood pressure
• Medicine to reduce the risk of a blood clot
• Cilostazol (Pletal) or pentoxifylline medication to specifically help minimize leg pain (claudication)
• Angioplasty (a small balloon is inflated to open the artery and a mesh stent is inserted to hold the artery open)
• Bypass surgery (a vessel from another part of your body is grafted to allow blood to flow around the narrowed artery)
• Thrombolytic therapy (a clot-busting drug is injected into the artery to break up the clot)

 If you have one or more of the risk factors for PAD, call 708-489-7925  today to schedule an appointment with an interventional cardiologist at MetroSouth Medical Center.