Arteriosclerosis
is the most
common cause
of chronic
arterial occlusive
disease of
the lower extremities.
The arterial
narrowing or
obstruction
that occurs
as a result
of the arteriosclerotic
process reduces
blood flow
to the lower
limb during
exercise or
at rest. Symptoms
usually do
not appear
until the artery
has narrowed
by 60 percent
or more.
Peripheral
Arterial
Disease (PAD)
progresses
through time
at variable
rates in
each individual.
It can build
up over a
lifetime,
and the symptoms
may not develop
until later
in life.
Five percent
of men and
women of
ages 55 to
75 have symptoms
of PAD. Seventeen
percent of
men and women
of the same
age group
have PAD
and no symptoms.
Fifteen to
twenty percent
of PAD patients
will progress
from claudication
(leg pain
on walking)
to critical
leg ischemia.
Four percent
of patients
with claudication
will have
progressive
disease and
resulting
in amputation.
Twenty-five
percent of
PAD patients
will require
a surgical
intervention
for revascularization.
Arteriosclerotic
disease is
a general
disease of
the vascular
system and
affects the
whole body.
Ten percent
of PAD patients
have cerebrovascular
disease.
Twenty-eight
percent have
coronary
artery disease.
The five-and-fifteen-year
mortality
after the
diagnosis
of PAD is
30 and 70
percent respectively,
compared
with 10 and
30 percent
in a similar
age group
without PAD.
Risk factors
for PAD are
ages 50 or
over, diabetes,
history of
coronary
artery disease,
smoking,
high blood
pressure,
and high
cholesterol.
Patients
with PAD
have leg
pain while
walking,
cold feet,
blue skin
color, and
foot and
toe sores
that do not
heal, or
reoccur.
Treatment
of PAD at
the first
stages involves
antiplatelet
therapy,
control of
high blood
pressure,
diabetes,
high cholesterol
and smoking.
An exercise
program and
daily care
of the feet
is essential.
As PAD progresses
to more advanced
stages, non-healing
wounds, severe
leg pain
or discoloration
of toes and
feet, and
revascularization
need to be
considered.
New minimally
invasive
techniques
enable us
to increase
the blood
flow to the
legs and
feet so patients
are able
to walk,
heal the
wounds, and
avoid limb
loss. Angioplasty
and Intravascular
Stent placement
increases
blood flow
to the legs
and helps
avoid prolonged
hospitalizations,
extensive
surgeries
and general
anesthesia,
while in
an outpatient
setting.
Surgical
interventions
like bypass
surgeries
are still
available
to patients
for whom
minimal invasive
surgery is
not applicable.
Approximately
80 percent
of patients
are able
to improve
blood flow
to the legs
using a minimally
invasive
technique.
