Peripheral Vascular Specialist- An Analysis
Peripheral arterial disease, commonly referred to as PAD, is clogged arteries in the leg that warn of widespread cardiovascular disease and typically is a warning sign for stroke or heart attack. The risks for PAD are the same as for heart disease: hypertension, diabetes, high cholesterol, smoking, obesity and family history. The more risk factors that you have, the higher your risk will go. People who are diagnosed with PAD are two to four times more likely to also develop coronary artery disease (CAD) and their heart attack risk climbs to 20-60% higher. see more
The symptoms of PAD include leg muscle discomfort, fatigue or a pain that may occur in the buttocks, thighs or calf muscles when you are walking or when you are working out. In half of the diagnosed cases of the disease, however, there are no symptoms that are reported or noticed at all or it may be dismissed as leg strain, arthritis or other causes. The longer that PAD goes untreated, however, the more serious it will become, eventually leading to the need for amputation.
Early detection and treatment of PAD is the key to keeping it from getting to that point. The test for PAD is typically an ankle-brachial index. The test involves taking blood pressure readings in the arm and then the ankle. The two numbers are compared: the ankle number should be the same or slightly higher than the one in the arm. A good score for the ankle-brachial index is 1 or 1.1 – at or below.95, you have enough narrowing in the blood vessels in your leg to warrant further examination, with tests that range from an ultrasound of the leg to MRI or CT scans.
For early PAD, walking is considered to be the first and best line of treatment. If the PAD is advanced or the patient refuses to comply with the walking order, the next step will be surgery, typically an angioplasty procedure of the leg. Angioplasty below the knee is not considered to be as effective or as durable a surgery as that which is done above the knee. A bypass is another surgical option that might be considered if the symptoms are severe enough or if there is danger of the leg being lost completely. In most cases, a blood thinner will be prescribed, however, the surgeries and medications are only part of the treatment plan for the long term. Identifying and eliminating as many of the risk factors as possible is also a key to PAD treatment.
Knowledge is the key to PAD’s treatment as well. In a study that was published in Circulation, Dr. Alan T. Hirsch. M.D., Adjunct Professor of Epidemiology and Community Health at the University Of Minnesota School Of Public Health in Minneapolis, found that through a survey of 2500 Americans adults aged 50 or over, only 26% knew what PAD was or knew that it was associated with heart disease and/or stroke. Only 14% of those surveyed knew that it could potentially lead to amputation.