What is peripheral artery disease?
Early diagnosis and treatment is critically important to prevent severe damage
Many people associate vascular disease with the heart and brain, and the danger of having blocked arteries near those vital organs. But the most common circulatory problems are farther away—in the hands, arms, legs and feet. This condition is called peripheral artery disease (or PAD), and the threat of PAD is compounded by the fact many people are unaware they're at risk for it.
"PAD is caused by atherosclerosis, or fatty deposit build-ups in the arteries that narrow or block blood flow to the extremities," said John F. Eidt, MD, RVT, RPVI, FACS, vascular surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas, and Chair of Vascular Surgery. "The reduced blood flow can cause permanent damage that kills tissue or encourages infection that leads to the loss of limbs."
How do I know if I have PAD?
Many PAD diagnostic techniques are painless
"Many patients with peripheral artery disease in their lower extremities experience painful muscle cramping in their hips, thighs or calves when walking, climbing stairs or exercising," said Dr. Eidt. "In severe cases, leg pain may persist even after finishing exercise. Other signs are wounds on the feet or toes that heal slowly or not at all, gangrene or a significant difference in the temperature of one lower leg or foot when compared to the other."
For people experiencing peripheral artery disease symptoms or with a family history of vascular disease, Baylor Scott & White Heart and Vascular Hospital – Dallas PAD specialists have various diagnostic techniques, most of them non-invasive and painless. The most common peripheral artery disease diagnosis method is the Ankle-Brachial Index (ABI), which compares blood pressure in the feet with blood pressure in the arm to evaluate blood flow through the body. Other methods to diagnose PAD involve sophisticated imaging procedures.
More than 8 million Americans have PAD
The American Heart Association estimates more than 8 million Americans have peripheral artery disease, with the incidence growing as people age. As is the case for many health problems, smoking is the leading risk factor, but diabetes, high blood pressure, obesity and high cholesterol also contribute to peripheral artery disease.
Non-invasive peripheral artery disease treatment options
Individuals are eligible to receive supervised exercise therapy (SET) if diagnosed with PAD caused by arterial insufficiency, and if classic intermittent claudication (IC) is present. Exercise training helps slow the decline in the ability to function and move through daily activities.
"The best treatment for peripheral artery disease frequently involves a combination of lifestyle changes and medications, rather than invasive procedures or surgery," said Dr. Eidt. "Stopping smoking, getting blood pressure under control, exercising, eating a diet low in saturated and trans fats, and effectively managing diabetes are the most common treatments for PAD. Supervised exercise therapy is helpful and many insurance plans, including Medicare, often cover it. We may also prescribe medicine to lower blood pressure and cholesterol, and blood thinners to help prevent the formation of blood clots."
When these approaches are not enough, Baylor Scott & White Heart and Vascular Hospital – Dallas and Baylor University Medical Center, part of Baylor Scott & White Health can provide peripheral artery disease treatment with the same expertise and technology they draw on to battle heart disease, including angioplasty, which uses a tiny, balloon-tipped catheter inserted into the blocked artery to open it up by expanding the balloon. A wire-mesh tube, called a stent, is often placed in the newly opened artery through the catheter to maintain normal blood flow after treatment for peripheral artery disease in Dallas.
"In many, if not most cases, we can slow PAD's progression—or even reverse it—without surgical measures," Dr. Eidt said. "The key is to be aware of the dangers, maintain a heart-healthy lifestyle and come see us if you think you have a problem."
Peripheral artery disease (PAD) procedures
Lower extremity stenting
To treat patients with leg pain caused by an artery blockage in the leg, a type of peripheral artery disease, vascular surgeons on the medical staff at our heart hospital in Dallas perform a surgical procedure called lower extremity stenting. In this peripheral artery disease treatment procedure, the vascular surgeon places a wire-mesh tube (called a stent) into the artery to keep it open, rerouting the blood supply around the occluded artery.
Lower extremity bypass surgery
An additional treatment option for artery blockage in the leg is lower extremity bypass surgery. Surgeons graft a vein from a different part of the body and attach it to the blocked artery, above and below the obstruction. This transplantation creates a new path for blood to flow around the blockage.
Upper extremity stenting
When artery blockage affects the blood supply to the arms and hands, a surgical procedure known as upper extremity stenting may be an option. Vascular surgeons on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas insert a stent (a small metal tube) into the blocked artery to facilitate blood flow and redirect the blood supply around the obstructed artery.
Upper extremity bypass surgery
Another treatment for arm artery disease that the vascular surgeons at our Dallas heart hospital perform is upper extremity bypass surgery. In this vascular procedure, surgeons transplant a vein from another part of the patient's body and attach it to the clogged artery, above and below the obstruction. This process creates a new route for blood to move around the obstruction.