Peripheral Artery Disease (PAD) FAQs

What is PAD?

It is narrowing or hardening of the arteries in the vessels that carry blood to your limbs. In the legs, this reduced blood flow can cause cramping and pain.  When this process affects arteries in the heart it is called coronary heart disease.

Which Arteries are Affected?

In PAD, the arteries in the legs are affected, and can also affect arteries in the kidneys, stomach, and arms.

What Causes PAD?

Atherosclerosis. Atherosclerosis is a buildup of fatty deposits in the arteries.

What Causes Atherosclerosis

Atherosclerosis is a slow build up of these fatty deposits, caused by smoking, high blood pressure, high cholesterol and high blood sugar. This damages the vessel walls. When the artery walls are damaged, the body recruits white blood cells to repair the damage. The white blood cells, and the fatty deposits become plaque, which narrows and eventually blocks the vessel. As we age, the plaque hardens and narrows the vessels, making it more difficult for oxygen-rich and nutrient- rich blood to reach your limbs, and other parts of the body

What are the Symptoms?

Some people have no symptoms. Symptoms commonly appear as tight, achy pain in the muscles of the legs, buttocks and thighs while walking or climbing stairs. This is called claudication. When the ache or pain stops at rest, it is called intermittent claudication, a key symptom of PAD.

Weak legs, problems walking or balancing, cold, numb feet and toes, sores that won’t heal, foot pain at rest and erectile dysfunction are other symptoms. Severe PAD can cause changes in the skin of the feet and legs.

Is It a Serious Disease?

PAD is a warning that you are likely to have more serious circulation problems, including heart disease, the number one killer in the U.S.

Is It Treatable?

Yes. It is important to treat the underlying atherosclerosis, as well cleaning out the plaques.

What are the Risk Factors?

• Even if you quit smoking, you are at increased risk.
• Age- Over age 50.
• Ethnicity- African American.
• Heart attack or diagnosed heart disease.
• A family history of PAD, heart disease or heart attack and stroke.
• Vascular disease, diabetes, high cholesterol, high blood pressure, heart disease and stroke increase your risk of developing PAD.

When Should You See a Doctor?

You should see a vascular surgeon at South Valley Vascular if you experience leg pain while walking that goes away at rest, you have foot or toe pain at rest, or wounds on your legs or feet that won’t heal.

What Tests are Used to Diagnose

• An ankle-brachial index (ABI) test compares blood pressure in your ankles to blood pressure in your arm.
• A Doppler Ultrasound looks at blood flow through the major arteries. It is used to evaluate the severity of the disease and reveal blocked blood vessels.
• A treadmill test can assess leg pain, the severity of your symptoms, and the level of exercise that causes your symptoms.
• A magnetic resonance angiogram (MRA) is a test that is used to evaluate the blood vessels for plaques.
• An arteriogram is a test used to identify the location of a known blockage. It uses an X-ray and dye which is injected into an artery. The dye makes the artery visible and helps to locate a blockage, it’s type and extent.
• Blood tests to check for diabetes and high cholesterol.

What Medications Treat PAD?

Medication is targeted at treating risk factors, easing leg pain, and improving circulation.

• Aspirin to prevent blood clots
• Treating high cholesterol with statin drugs can help lower your numbers and reduce your risk of complications of PAD.
• Lowering blood pressure with drugs
• Medications can help ease leg pain while walking and reduce symptoms

Will Nutritional Supplements Help?

Taking Vitamin C, Vitamin E, ginkgo biloba, garlic and carnitine may help reduce leg pain and improve circulation. Talk with your vascular specialist at South Valley Vascular.

When is Surgery an Option?

When lifestyle changes are insufficient to control PAD, surgery may be indicated to restore blood flow and prevent the loss of the limb. But, none of these procedures will address the underlying cause- atherosclerosis.

Types of Surgery:

• Bypass grafting is surgery to bypass the blocked part of an artery, by grafting a blood vessel from another part of your body, or using a man-made graft. It is not a cure, but will increase blood flow to the affected leg.

• Angioplasty is surgery to widen a narrowed or blocked artery to restore blood flow. This procedure uses a thin tube with a balloon which is inserted into the artery, the balloon is inflated and compresses the plaque against the artery walls.

• During angioplasty a small mesh tube or stent can be placed in the artery to keep it open. Sometimes the stent is coated with medicine to help prevent blockages.

• Atherectomy is a surgical procedure to remove the built up plaque in the artery. A thin tube is inserted with a cutting device on the end. It is used to shave or cut away the plaque, which is then removed with the catheter, or washed away with the blood. Some doctors use a special laser to dissolve the plaque.

Can PAD Be Prevented?

Efforts to reduce your risk factors can help prevent or delay the onset of PAD, and its complications. Lifestyle changes include quitting smoking, eating a heart healthy diet, and losing weight, and exercise. All of these can reduce symptoms and improve your quality of life, as well as reduce your risk for heart attack, heart disease and stroke.

When you have PAD, it is important to take good care of your feet and legs.

• Poor blood flow to these areas puts you at risk for minor injuries that lead to major infections.
• Treat all wounds immediately. If they don’t heal see a doctor.
• Avoid too tight shoes, and compression stocking that can worsen circulation problems
• Keep your feet clean and dry.
• Moisturize skin on feet and legs.

The board-certified vascular specialists at South Valley Vascular in Visalia, Porterville and Hanford, California specialize in diseases of the arteries and veins. When you have circulation problems, you can trust us with your care. You will receive a correct diagnosis and compassionate, quality care. Call us today at (559) 625-4118 and schedule your consultation today!