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Peripheral Artery Disease

Peripheral Artery Disease Questions

Questions And Answers

How do people get PAD?

Smoking is the most common risk factor for PAD. People who smoke have ten times greater chance of developing significant PAD than non-smokers. Other medical conditions that increase the risk of PAD include diabetes, elevated cholesterol, high blood pressure, obesity and family history of PAD.

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What are the symptoms of PAD?

People with mild PAD usually complain of pain in the calves or thighs after short episodes of exercise follow by relief of the pain after short periods of rest. This is referred to as claudication and usually occurs after one to two blocks of walking or less. More advanced stages of PAD will present as pain in the feet while sleeping;  which may be relieved by dangling the feet. Other presentations of advanced PAD include non-healing ulcers, or gangrene.

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When should someone see a doctor for PAD?

People should be evaluated by a doctor if they are experiencing pain in the legs with short periods of exercise, even if it is only a mild annoyance. Early detection and treatment is important not only for the health of the legs but for the prevention of heart disease and stroke since PAD is frequently a sign of other vascular problems. Certainly, people with severe pain at rest or discolored, painful toes should see a physician as soon as possible.

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How is PAD treated?

Patients with PAD are generally referred to a vascular surgeon. After doing a thorough history and physical exam, non-invasive testing is frequently performed to evaluate the severity of PAD. Arterial dopplers are a simple non-invasive test that measures the flow to the feet in comparison to that of the arms. If the initial tests suggest significant disease, more advanced studies such as an angiogram or MRI may be needed to better define the problem.

Once significant PAD is identified, treatment options need to be discussed with the physician. Mild to moderate stages of PAD can frequently be treated with exercise, smoking cessation, and medication. More advanced cases of PAD may require endovascular repair or surgery.
Endovascular treatment is when a partial or total blockage of the artery is opened with a balloon or a stent. This is done under local anesthesia through a catheter that is inserted in the groin. This method of intervention is fast becoming the treatment of choice for many types of PAD. This is usually done as an outpatient with minimal pain and quick recovery. If an endovascular approach is not feasible due to the severity of disease, a surgical bypass may be needed to improve blood flow to the legs.

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What can people do to reduce their risk of developing PAD?

  1. Stop smoking: Smoking is a significant risk factor for PAD and people who stop smoking can substantially reduce their symptoms as well as their risk of more severe problems in future.
  2. Exercise: Exercise not only conditions your heart and lungs but also helps your muscles adapt to the reduced blood flow. A regular exercise program may eliminate mild symptoms of pain with walking.
  3. Control cholesterol and fat: This will help not only to reduce the build up of plaque in the legs, but decrease the probability of having a heart attack or stroke as well. Cholesterol and fat can many times be controlled by diet modification but may also require medication.

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