Scarborough Vascular Ultrasound
Peripheral Artery Occlusive Disease (PAOD)
What is peripheral arterial disease(PAD)?
Answer: Peripheral arterial disease, or PAD, is a condition in which the arteries that carry blood to the arms or legs become narrowed or clogged, interfering with the normal flow of blood. The most common cause of PAD is atherosclerosis (often called hardening of the arteries). Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, firming a substance called ”plague” that clogs the blood vessels. PAD may also be caused by blood clots.
Answer: The disease, which affects both men and women, often goes undiagnosed and many people mistakenly think the symptoms are a normal part of aging.
The most common symptoms of PAD is called intermittent claudication, a painful cramping in the leg or hip, particularly when walking. Intermittent claudication occurs when there is not enough blood flowing to the leg muscles during exercise. The pain typically goes away when the muscles are given a rest.
Other symptoms may include numbness, tingling or weakness in the leg. In severe cases, you may experience a burning or aching pain in the feet or toes while resting, or develop a sore on the leg or foot that does not heal. People with PAD may also experience a cooling or color change in the skin of the legs or feet, or loss of hair on the legs. In extreme cases, untreated PAD can lead to gangrene, a serious condition that may require amputation of a leg or a foot.
If you have PAD, you are also at higher risk of heart disease and stroke.
Answer: As many as 1 million Canadians have PAD. It is estimated that 4 million of those suffer leg pain symptoms. These who are at highest risk are:
A family history of heart or vascular disease many also put you at higher risk for PAD.
Answer: The most common test for PAD is the ankle-brachial index (ABI), a painless exam in which ultrasound is used to measure the ratio of blood pressure in the feet and arms. Based on the result of your ABI, as well as your symptoms and risk factors for PAD, the physician can decide if further tests are needed. PAD also can be diagnosed non-invasively with an imaging technique called magnetic resonance angiography (MRA|, or with computed tomography (CT) angiography.
Answer: The best treatment for PAD depends on a number of factors, including your overall health the severity of the disease. In some cases, lifestyle changes are enough to halt the progression of PAD and manage the disease. Your physician may prescribe drugs when lifestyle changes are not enough. Procedures that open clogged blood vessels also are sued to treat PAD.
Lifestyle changes. Most treatment plans will include a low fat diet and a program of regular exercise. If you are a smoker, it is absolutely essential that you stop the use of all types of tobacco. If decreased blood flow to the legs is causing injury to the feet and toes, a foot care program to prevent sores or infection may be prescribed. This may include referral to a podiatrist.
Medication: Medications that lower cholesterol or control high blood pressure may be prescribed. Medication also is available that has been shown to significantly increase pain-free walking distance in people with intermittent claudication. Other medications that help prevent blood clots or the build-up of plague in the arteries are available, as well.
Answer: There are a number of ways that physicians can open blood vessels at the site of blockages and restore normal blood flow. In many cases, these procedures can be performed without surgery using modern, interventional radiology techniques. Interventional radiologists are physicians who use tiny tubes called catheters and other miniaturized tools and X-rays to do these procedures.
Procedures performed by interventional radiologists include:
Sometimes, open surgery is required to remove blockages from arteries or to bypass the clogged area. These procedures are performed by vascular surgeons.
Answer: If you suspect that you may have PAD, it is important that you see your personal physician for an evaluation.
Answer: Interventional radiologists are doctors who specialize in minimally invasive, targeted treatments performed using imaging for guidance. They use their expertise in reading X-rays, ultrasound, MRI and other diagnostic imaging, to guide tiny instruments, such as catheters, through blood vessels or through the skin to treat diseases without surgery. Interventional radiologists are board-certified and fellowship trained in minimally invasive interventions using imaging guidance. Your interventional radiologist will work closely with your primary care or other physician to be sure you receive the best possible care.