Are You at Risk? Ask your Doctor about Peripheral Artery Disease
One in 20 Americans older than age 50 have peripheral artery disease or PAD, placing them at higher risk for a heart attack or stroke. Medical College of Wisconsin vascular medicine physician James Gosset, MD, discusses the risks associated with PAD and treatment options.
Q. What is peripheral artery disease (PAD)?
PAD affects arteries outside the heart – mainly in the legs. However, it can affect other arteries as well. PAD develops when the peripheral arteries become clogged with fatty deposits (plaque), causing them to narrow and reducing the flow of blood and oxygen to the muscles. Plaque buildup (atherosclerosis) occurs over many years.
Q. What are the signs and symptoms?
Symptoms depend on which arteries are affected and to what extent blood flow is restricted. Some people may have no symptoms, while others have mild to severe symptoms. Mild symptoms include claudication – intermittent cramping, discomfort and pain in the buttocks, thighs and legs when walking – which goes away after a few minutes. In more severe cases, there may be pain in the legs and/or feet that disturbs sleep, and open ulcers or sores on the legs or feet. Most people with PAD do not have typical signs and symptoms.
Q. Is PAD serious?
Yes. Even mild cases of PAD increase a person’s risk for heart attack and stroke. There’s a significant association between PAD and plaque buildup in other areas of the body – it’s just a matter of how much.
Q. Who is at risk for PAD?
The risk factors for cardiovascular disease – smoking, high cholesterol, high blood pressure, diabetes and age – are the same for PAD.
Q. Is PAD commonly diagnosed?
PAD is under-diagnosed and under-treated. Because symptoms may be mild or absent, physicians don’t test for PAD as much as they should. The disease is often diagnosed after it’s progressed and there are symptoms. Also, PAD patients aren’t treated as aggressively – in terms of risk factors – as are patients with atherosclerosis of the aorta or carotid artery. They’re not viewed as sick. But they are, and their disease can lead to a heart attack or stroke.
Q. How is PAD diagnosed?
A simple, painless test called an ankle-brachial index (ABI) compares blood pressure readings in a person’s ankles with blood pressure readings in the arms. If PAD is present, imaging (ultrasound or angiography) can pinpoint the specific artery that is blocked. Patients, especially those over age 50, should ask their physician to check them for PAD.
Q. How is PAD treated?
Treatment may involve lifestyle changes to reduce risk, treating the limb(s) to reduce disease progression, treatment to save the limb(s), and therapies to prevent the associated risk of heart attack or stroke. Medications may be prescribed to prevent blood clots and reduce discomfort when walking. Some patients need a combination of therapies. In severe cases, endovascular therapy – treating vascular disease from inside the blood vessel – may be needed. This involves angioplasty, a minimally invasive procedure in which a balloon catheter and a stent open a blocked artery. A third option is surgery that removes a vein from the leg.
Q. What makes PAD treatment unique at Froedtert & the Medical College?
We have the expertise of vascular surgeons, cardiologists and interventional radiologists who work together to offer the full range of treatment options for PAD. Our multidisciplinary approach makes us unique.
For information or an appointment, call 414-805-3666 or 800-272-3666.
Source: Froedtert Today
Date: August 2008