PERIPHERAL VASCULAR DISEASE (PVD)

ALSO KNOWN AS PERIPHERAL ARTERIAL DISEASE (PAD)

The surgeons at North Orlando Surgical Group have a combined total of 45 years of experience offering surgical services to the community.  We pride ourselves on providing the least invasive, innovative surgical techniques in an environment focused on quality care and exemplary customer service.  Our physicians have performed thousands of hernia repairs with a very low complication rate.  We recognize that surgery is a frightening proposition and we pride ourselves in assuring confidence in our abilities while getting you through the process with caring and compassion.

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Peripheral Arterial Disease is a disease in which plaque builds up in the arteries that carry blood to the head, organs and limbs.  Plaque is made up of fat, cholesterol, calcium, fibrous tissue and other substances in the blood.  Peripheral Arterial Disease or PAD is a very common condition affecting 12–20 percent of Americans age 65 and older although it can happen to anyone regardless of their age.

When plaque builds up in the bodies arteries, the condition is called atherosclerosis.  Over time, plaque can harden and narrow the arteries.  This limits the flow of oxygen rich blood to your organs and other parts of your body.  Peripheral Arterial Disease usually affects the arteries in the legs but it can also affect the arteries that carry blood from your heart to your head, arms, kidneys and stomach.   This can become a serious condition when left undiagnosed or untreated.

PAD increases your risk of coronary artery disease, heart attack stroke, transient ischemic attack (TIA also known as mini-stroke), gangrene of your limbs and even amputation of a limb if left untreated.  If you have coronary artery disease, you have a 1 in 3 chance of having blocked leg arteries.  Atherosclerosis can also accumulate in your internal carotid arteries which provide oxygen-rich blood to your brain.  Failure to treat carotid artery stenosis can result in a stroke.

 

The most common symptom of PAD is called intermittent claudication, which is painful cramping in the leg or hip that occurs when walking or exercising and typically disappears when the person stops the activity. Other symptoms include numbness, tingling and weakness in the lower legs and feet; Burning or aching pain in feet or toes when resting; Sore on leg or foot that won’t heal; Cold legs or feet; Color change in skin of legs or feet; Loss of hair on legs.  One of the most concerning symptoms is having pain in the legs or feet that awakens you at night and improves when you hand your legs off the bed.  This type of pain is known as ischemic rest pain.  Many people simply live with their pain, assuming it is a normal part of aging, rather than reporting it to their doctor.

Those who are at highest risk for PAD are:  Over the age 50; Smokers; Diabetic; Overweight: Inactive (and do not exercise); Have high blood pressure or high cholesterol or high lipid blood test or have a family history of vascular disease such as PAD, aneurysm, heart attack or stroke.

The most common test for PAD is the ankle-brachial index (ABI), a painless exam in which ultrasound is used to measure the ratio of blood pressure in the feet and arms. Based on the results of an ABI—as well as one’s symptoms and risk factors for PAD—a doctor can decide if further tests are needed. PAD also can be diagnosed noninvasively with an imaging technique called magnetic resonance angiography (MRA) or with computed tomography (CT) angiography.

There are various treatment modalities for PAD to include:  medication, lifestyle changes, angioplasty and stenting and surgery.

Medications that lower cholesterol or control high blood pressure may be prescribed. Medication also is available that been shown to significantly increase pain-free walking distance and total walking distance in individuals with intermittent claudication. Other medications that prevent blood clots or the buildup of plaque in the arteries are available as well.

Often PAD can be treated with lifestyle changes. Smoking cessation and a structured exercise program are often all that is needed to alleviate symptoms and prevent further progression of the disease.

Angioplasty and stenting involve using imaging guidance to thread a catheter through the femoral artery in the groin, to the blocked artery in the legs. A balloon in the inflated to open the blood vessel where it is narrowed or blocked. In some cases, this is then held open with a stent, a tiny metal cylinder. This is a minimally invasive treatment that does not require surgery, just a nick in the skin the size of a pencil tip.  Stenting and angioplasty are preferred as a first-line treatment

Sometimes, open surgery is required to remove blockages from arteries or to bypass the clogged area. These procedures are performed by vascular surgeons.

For more information regarding the prevention and treatment of PAD, call us today to schedule a consultation with a Board Certified Vascular Surgeon.


Do you need an appointment ? Please call today (386) 775-0333 or