Smokers are at a Greater Risk of PAD – Stents can treat the Condition.
Peripheral artery disease is a widespread circulatory condition where narrowed arteries limit blood flow to the arms or legs. The legs don’t receive enough blood flow to keep up with the demand of day to day walking. This causes symptoms, most notably leg pain when walking called claudication which disappears after a few minutes of rest but again pain starts when a person starts walking.
Peripheral artery disease symptoms include:
- Claudication refers to painful cramping in the hips, thighs, or calves that typically arises during activities such as walking or climbing stairs.
- Leg numbness or weakness
- A noticeable feeling of cold in one lower leg or foot, particularly when compared to the other side.
- Sores on toes, feet or legs that won’t heal
- A change in the color of legs
- Reduced hair growth or thinning hair on the legs and feet.
- Slower growth of toenails
- Shiny skin on legs
- Absent or weakened pulse in the legs or feet.
- Erectile dysfunction in men
If peripheral artery disease progresses, pain may occur even at rest or when lying down (ischemic rest pain). It may be intense enough to disrupt the sleep.
Causes
Atherosclerosis – fatty deposits (plaques) build up in the artery walls, thereby narrowing the lumen and reducing blood flow.
Less commonly, the cause of peripheral artery disease may be blood vessel inflammation, injury to the limb, unusual anatomy of ligaments or muscles pressing on the artery, or radiation exposure.
Several factors can raise the likelihood of developing peripheral artery disease.
- Smoking
- Diabetes
- Obesity (a body mass index over 30)
- High blood pressure
- High cholesterol
- Having close relatives with peripheral artery disease, heart disease, or stroke increases your risk.
- High levels of homocysteine, a protein component that helps build and maintain tissue
Individuals who smoke or have diabetes are at the highest risk of developing peripheral artery disease.
Complications
- Critical limb ischemia. This condition begins as open sores that don’t heal, an injury, or an infection of the foot or leg that progress and cause tissue death (gangrene), sometimes requiring amputation of the affected limb.
- Stroke and heart attack. Atherosclerosis that causes the signs and symptoms of peripheral artery disease can also build up in arteries supplying the heart and brain.
Prevention by Lifestyle changes
- Stop smoking.
- Supervised exercise program helping your body use oxygen more efficiently.
- Eat a healthy diet. Eating less saturated fat and adding more fruits and vegetables to your diet can help control your blood pressure and cholesterol levels, which contribute to atherosclerosis.
- Avoid certain cold medications. Over-the-counter cold remedies that contain pseudoephedrine, constrict your blood vessels and may increase your PAD symptoms.
- Careful foot care – People who also have diabetes, are at risk of poor healing of sores on the lower legs and feet. and increases the risk of infection. Inspect your feet daily for injuries.
- Elevate the head of your bed by 4 to 6 inches (10 to 15 cm), as positioning your legs below heart level can help reduce discomfort.
- Avoid cold temperatures as much as possible. Be sure to dress in warm layers.
Diagnosis –
- During a physical exam, a doctor may notice a weak or missing pulse below a narrowed artery, hear unusual whooshing sounds (bruits) over the arteries with a stethoscope, observe slow or poor healing of wounds in areas with reduced blood flow, and detect lower blood pressure in the affected limb.
- Ankle-brachial index (ABI). This test measures and compares the blood pressure in your ankle with that in your arm.
- Doppler ultrasound evaluates the blood flow through the blood vessels and identifies blocked or narrowed arteries.
- By injecting a dye (contrast material) into the blood vessels, the doctor can view blood flow through the arteries as it happens, using imaging techniques, such as X-ray imaging (intravenous angiography). or magnetic resonance angiography (MRA) or computerized tomography angiography (CTA).
- Catheter angiography is a more invasive procedure that involves guiding a catheter through an artery in the groin to the affected area and injecting the dye. While minimally invasive, this form of angiography provides clear imaging and enables both diagnosis and treatment at the same time—identifying narrowed blood vessels and then widening them or delivering medication to enhance blood flow.
Treatment
- Medicines to prevent blood clots so as to improve blood flow, to lower blood pressure (target is under 130/80 mm Hg), to lower cholesterol to less than 100 milligrams per deciliter (mg/dL) and to control pain and other symptoms by using vasodilators
- Thrombolytic therapy. If there is a blood clot blocking an artery, the doctor may inject a clot-dissolving drug into your artery at the point of the clot to break it up.
- Bypass surgery. Done in case of a long segment of blocked or narrowed artery. A graft bypass is created using a vessel from another part of the body or a blood vessel made of synthetic fabric
Non-surgical treatment involving the use of a stent to open a blocked artery.
This is most commonly performed treatment option in case of short segment block. In this procedure, a thin catheter is guided through a blood vessel to the affected artery. A small balloon at the tip is then inflated to compress the blockage against the artery wall and widen the artery, improving blood flow. Then a stent is inserted in the artery to help keep it open.
Best Treatment Option- Non-surgical treatment using stent to open the block.
Advantages of Interventional Non-surgical Treatment
- It is less risky as compared to surgery
- It is cheaper than traditional surgery.
- No surgical scar on skin.
- Procedure done under local anaesthesia.
- It is done as an outpatient (OPD) / day care or short hospital stay.
- Patients can resume normal activities within a day.
- It can fast relieve pain and suffering for many cancer patients
Its safety has been established over many years and confirmed in thousands of patients.
Dr. Pradeep Muley is trained in the USA and Singapore and has performed over 20,000 non-surgical treatments for various diseases like uterine fibroids, uterine adenomyosis, un-operable liver tumor, liver abscesses, varicose vein, brain aneurysm and vomiting of blood from lungs and stomach. He runs the VARICOSE VEIN AND FIBROID CLINIC AT FORTIS HOSPITAL, VASANT KUNJ, NEW DELHI & created INDIA’S 1ST UTERINE FIBROID CLUB. He has treated the maximum number of fibroid patients in India through the innovative Uterine Artery Embolization method.
For more in-depth information on various non-surgical treatments available-
Mail Us: muleypradeep@hotmail.com or Visit to Website: – www.indianinterventionalradiology.com
Phone or Whatsapp: +91-9810492778