Treatment for Peripheral Artery Disease (PAD) In Denver
Peripheral artery disease most often affects blood vessels in your legs, as arteries become blocked by a buildup of cholesterol. The radiologists at Minimally Invasive Procedure Specialists will provide an expert diagnosis and treatment plan based on your symptoms and lifestyle. If you are suffering from symptoms of PAD, contact Minimally Invasive Procedure Specialists to schedule your consultation today.
What is Peripheral Artery Disease (PAD)?
Arteries are high-pressure vessels that transport blood from the heart out to all tissues of the body. The aorta is the largest artery of the body, much like the trunk of a tree. The peripheral arteries are the branches. With arterial disease, the vessels may become narrowed or abnormally enlarged.
Common Symptoms of PAD
There are four common presentations of peripheral artery disease. These are acute limb ischemia, critical limb ischemia, claudication, and asymptomatic peripheral arterial disease. They are differentiated by the time course of the artery narrowing (slower is better), the body’s ability to grow or repurpose other vessels (more is better), and the clinical presentation of the patient. Both of these factors are affected by other medical problems and lifestyle choices, so each patient will have an individual care plan.
Acute limb ischemia is an emergency
It is caused by an abrupt blockage of the arteries of the limb. Causes of this are often not found but maybe from an upstream clot breaking off and floating downstream like a stick in a river. It may also be caused by blood clots forming in the blood vessels themselves. Typical symptoms are pain, a foot that is paler and/or colder than the opposite foot, numbness, or even inability to move the foot. The underlying reason is that the blood flow has been rapidly cut off and the body hasn’t had a chance to grow or repurpose other vessels to meet the need. Blood flow must be restored emergently.
Critical limb ischemia (also termed chronic limb-threatening ischemia) presents in two ways.
The first presentation is rest pain. This is pain that is present when the patient is not moving. Typically, this occurs at night or when the leg is elevated. Sometimes patients may find it more comfortable to get out of bed and walk around. Other coping strategies are dangling the leg out of bed or sleeping in a chair to allow gravity to improve the blood flow to the foot. The second presentation is wounds. A non-healing wound of the foot should be evaluated quickly. Wounds may also progress to death of a toe or the foot, gangrene, where the tissue is irreparably damaged by lack of blood flow. Blood flow must be restored to resolve the symptoms, heal the wound, or reduce the level of amputation for gangrene. The diagnosis of critical limb ischemia is a major medical problem. Survival rates for many cancers are better.
Claudication is pain with walking
These patients have enough blood flow to keep the legs healthy, but when there is increased blood demand from the muscles there isn’t enough to supply them. Symptoms are pain or cramping in the leg that starts with muscle use such as walking, stairs, or exercise and stops when the patient stops. Treatment for this starts with medicine, risk factor modification (stop smoking!), and exercise. If this fails, the patient may require further intervention.
Asymptomatic peripheral artery disease is a silent killer.
This is a diseased arterial tree that hasn’t caused any symptoms yet. The arteries are a single organ that course throughout the body. Disease of the arteries is global. This means eventual development of the limb diseases above, but it also means disease of the vessels in the heart (heart attack) and to the brain (stroke). It is estimated that 10% of the population over 55 has this disease.
How is Arterial Disease Diagnosed?
We diagnose arterial disease with a clinic visit and in-office testing. For some patients, this may mean a blood pressure cuff on the legs, an ultrasound, a cat scan, an MRI, or an angiogram (placing a small tube into the blood vessel and taking X-rays). Patients generally do not need all of these tests.
How is Arterial Disease Treated?
Our specialists treat arterial disease with a whole-patient approach. Many of our patients are surprised by the lifestyle changes, provider coordination, and medications we suggest.
- Lifestyle modifications. If you’re a smoker you will need to quit. We have resources to help. As we deal with patients just like you every day, we understand how hard and trying this can be. If you’re a diabetic we may need to look at your A1C and dietary modifications. Most importantly, exercise. You will need to walk, every single day. It helps the legs, the heart, and the brain.
- Medical management . We’ll review your medications and likely add medications. For claudicants and asymptomatic patients, lifestyle modifications and medical management may be all that is required.
- Arteriography. Just as we can use a tiny tube to evaluate your vessels, we can introduce tiny tubes that treat your vessels. This may include balloons, stents, drugs, and devices. For patients with rest pain, wounds, gangrene, or acute limb ischemia this is likely the preferred way of treatment.
It is important to note that while these presentations seem to be on a spectrum. They may not progress in a stepwise fashion. Not all claudicants will progress to critical limb ischemia, and not all critical limb ischemia patients were claudicants. Some acute limb ischemia patients may not have any significant arterial disease at all. Every patient is different, and every patient has an individualized care plan.
Why Choose Minimally Invasive Procedure Specialists
Treatment for PAD in Denver
If you still have questions regarding treatment for PAD, we encourage you to schedule an appointment with MIPS Center today by calling (303) 805-7477. You may also request an appointment online using our secure form.