Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a very common condition affecting 12-20 percent of Americans age 65 and older. PAD develops most commonly as a result of atherosclerosis, or "hardening of the arteries," which occurs when cholesterol and scar tissue build up, forming a substance called plaque inside the arteries that narrows and clogs the arteries. This is a very serious condition. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking, and eventually gangrene and amputation.
Treatments
Lifestyle - 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. Like many patients with coronary artery disease caused by atherosclerosis, PAD patients frequently have elevated cholesterol levels that contribute to the disease. A low fat diet and other cholesterol-lowering strategies are often part of a treatment plan.
Medication - For many patients, lifestyle changes combined with medication can control the symptoms of PAD. Drugs that lower cholesterol or control high blood pressure may be prescribed. New medications that help prevent blood clots or the build up of plaque in the arteries, or that reduce the pain of PAD, also are appropriate for some patients.
Angioplasty and stenting - Interventional radiologists pioneered angioplasty and stenting, which was first performed to treat peripheral arterial disease. Using imaging for guidance, the interventional radiologist threads a catheter through the femoral artery in the groin, to the blocked artery in the legs. Then the interventional radiologist inflates a balloon 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.
Cryoplasty - Cryoplasty is the newest type of angioplasty that uses a freezing technique to open the artery. In the smallest vessels, the artery is more likely to re-narrow over time. In these cases, cryoplasty may be a better choice. In this newer procedure the balloon is filled with nitrous oxide which freezes the plaque inside the artery during the angioplasty. Freezing the plaque causes cell death in the plaque and breaks up the plaque. This is believed to aid in reshaping the plaque with minimal injury or inflammation to the vessel wall.
Surgery - Surgery is sometimes required to remove blockages from arteries or to bypass the clogged area. These procedures are performed by vascular surgeons.
Contact Information and Scheduling
The Interventional Institute
Holy Name Hospital
201-833-3310