By Jose L. Trani, Jr., MD, Vascular Surgeon, Department of Vascular and Endovascular Surgery
Nearly 10 million Americans suffer from Peripheral Arterial Disease (PAD), which is a potentially serious but treatable circulation problem that usually affects the arteries in the legs.
PAD is a disease in which plaque – deposits of fat, cholesterol, and other substances in the blood – builds up in the arteries and, over time, can severely narrow or completely block the flow of oxygen-rich blood to the limbs. This can lead to extreme pain and tissue loss, and significant problems with walking.
In severe cases of PAD, a total loss of circulation to the legs and feet can lead to gangrene and amputation.
Diagnosing PAD
The most common symptoms of PAD are cramping, pain or tiredness in the leg or hip muscles while walking or climbing stairs. Typically, this pain goes away with rest but returns when the activity is resumed. Many people mistake the symptoms of PAD for something else, and the condition often goes undiagnosed by healthcare professionals.
However, PAD can be easily and painlessly diagnosed by measuring the blood pressure in the arm and comparing it to the pressure at the ankle, called the ankle-brachial index (ABI). If the pressure or ABI is less than 1.0, arterial disease is present.
Managing PAD
As a surgeon specializing in vascular and endovascular surgery, I routinely see patients with PAD. The good news for these patients is that pursuing a healthier lifestyle and following a physician’s advice can often help in managing PAD, significantly reducing the need for surgical intervention.
For most patients, a healthier lifestyle includes smoking cessation, maintaining good control of blood sugars (for diabetics), and eating a diet low in fat and sodium, and rich in fruits and vegetables.
Additionally, all patients with PAD should take aspirin or Plavix, as well as a statin (cholesterol medicine).
Finally, exercising for 20 to 30 minutes a day, four or five days per week, has proven to be beneficial.
Treating PAD
Unfortunately, some patients need more than medical management for their PAD and will require a procedure to improve their blood flow.
For patients with pain while resting, or those with tissue loss, we discuss surgical treatment options to restore blood flow to the legs and feet in order to prevent amputation.
For patients with claudication symptoms, or pain while walking a short distance, we discuss medical management strategies first. Intervention for these patients is reserved for individuals who have a significantly reduced quality of life due to their inability to walk.
Living With PAD
As is the case with many chronic illnesses, the physician-patient relationship is extremely important for achieving success in the management of PAD. Through open communication, and sometimes difficult work on the part of both the patient and the physician, the quality of life for the patient with PAD can significantly improve.
If you have leg pain, numbness or other symptoms, don’t dismiss them as a normal part of aging. PAD diagnosis and treatment can slow or stop disease progression and reduce the risk of complications.