Peripheral Arterial Disease

What is Peripheral Arterial Disease (PAD)?

Your arteries carry fresh, oxygenated blood from your heart, while your veins carry the old blood back to your heart and lungs. But as you age, one or more of your artery linings may change from being smooth to becoming irregular as plaque, a buildup of fat, cholesterol or calcium, occurs. When you develop PAD, your extremities, usually your legs, do not receive enough blood in order to keep up with the demand.

Who Is At Increased Risk for PAD?

The rate at which PAD progresses varies with each individual and depends on many factors, including where in the body the plaque has formed and the person’s overall health. If you have any of the following, a Duplex Doppler Ultrasound Scan can be performed to diagnose PAD. This simple, painless test does not involve needles or dye and is performed in our Vascular Lab.

  • High cholesterol levels
  • High triglyceride levels
  • High blood pressure (hypertension)
  • Diabetes
  • Family history of PAD or heart disease
  • Obesity
  • Sedentary lifestyle and lack of exercise
  • Previous stroke
  • Current or previous smoker

When our vascular surgeons examine patients with PAD, certain findings may be discovered including:

  • Absent pulses in the foot or leg
  • A noise in the artery caused by a turbulent blood flow, called a bruit
  • A cool temperature in the foot or leg
  • A pale color when the foot is elevated
  • Decreased hair or tissue fat
  • Open sores or black areas of gangrene

What Tests Are Available for Peripheral Arterial Disease?

Simple, painless tests at DVVI can be performed to diagnose PAD. These tests don’t involve needles or dye and are usually performed in our Vascular Lab. It’s also important to note that your test will be performed in a lab that is accredited by the Intersocietal Commission on the Accreditation of Vascular labs (ICAVL), as ours is.

Duplex Doppler Ultrasound Scan: To get a picture of where your blockage is, the latest in ultrasound technology is used to painlessly and non-invasively produce pictures showing the blood vessels and their flow. This is a process similar to radar.

Magnetic Resonance Scans (MRI and MRA): This technology which relies upon highly powered magnets to align water molecules in the body tissues can provide a road map of the arteries. It is a painless and fairly rapid form of assessment especially on the latest machines. However, they can’t be used in patients who have steel implants such as pacemakers. MRA is becoming an increasingly popular imaging technique for blood vessels.

Arteriograms: When some form of invasive treatment is planned, an arteriogram may be performed. An arteriogram is an outpatient procedure that involves injection of dye into the blood vessels of the lower extremities. Arteriograms can diagnose peripheral arterial disease with great accuracy and treatment of the blocked artery can be performed in the same setting.

How is PAD Treated by Desert Vein and Vascular Specialists?

An atherectomy is a procedure that utilizes a catheter with a sharp blade on the end to remove plaque from a blood vessel. You may need this procedure if your arteries become too narrowed or blocked from plaque inside the artery walls. If arteries are blocked, blood cannot get through to nourish the tissues, causing the muscles of the lower extremities to cramp and lose strength.

The goal of treatment is to reduce the build-up of plaque in your arteries. With atherectomy, the catheter is inserted into the artery through a small puncture in the artery, and it is performed under local anesthesia. The catheter is designed to collect the removed plaque in a chamber in the tip, which allows removal of the plaque as the device is removed from the artery. (watch this video to see how this procedure works).

The process can be repeated at the time the treatment is performed to remove a significant amount of disease from the artery, thus eliminating a blockage from atherosclerotic disease.