Peripheral Artery Disease and Its Prevention By Dr. Jeffrey J. Stein
Peripheral Arterial Disease, or PAD, is a disease that leads to the blockages of arteries. These blockages can lead to a reduction, or a complete restriction, of blood flow to the leg. This concerning circulatory condition can cause a constellation of symptoms, from leg pain to non-healing wounds, and may result in limb loss, if not quickly and expertly diagnosed and treated. According to the Amputee Coalition, San Antonio does have one of the highest amputation rates in the nation. This makes prevention, early detection and early treatment very important.
What are the risk factors for PAD?
PAD risk factors are similar to the risk factors for arterial disease in the heart and neck. Risk for PAD is increased for the male sex, and in persons with increased age, high blood pressure, high cholesterol, tobacco use, diabetes and kidney disease.
What are the symptoms of PAD?
The most common symptom is leg pain, especially in the muscles when walking. If caught at this point, the disease is most likely easily managed, and risk factors can be modified. As PAD becomes more severe, it can cause pain in the tips of the toes at night that improves with hanging the leg over the edge of your bed, discoloration of the lower leg, and open sores or wounds that do not heal due to lack of blood flow and poor circulation.
How is PAD diagnosed?
Physicians can detect if a patient may be at increased risk for, or currently suffering from, PAD by asking if they have the risk factors. Additionally, physicians can perform a physical exam of the patient’s legs, and check for the pulses in their feet. If PAD is suspected, the physician should refer the patient to a vascular surgeon. Vascular surgeons are expertly trained at testing, diagnosing and treating PAD The vascular surgeon will order an ultrasound to confirm the diagnosis.
How is PAD treated?
Initial treatment of mild PAD is aimed at modifying the patient’s risk factors, along with walking daily, and the use of antiplatelet medication. Depending on the severity of PAD, further treatment may include taking pictures from inside the arteries, with attempts to open up the blockages in a minimally invasive fashion, or open surgery.
How can PAD be prevented?
What steps can patients take to lower their risk and manage their PAD symptoms?
- Quit smoking. Smoking significantly increases the formation of plaque in arteries, and is one of the leading risk factors for PAD.
- Eat a balanced diet. A healthy diet helps maintain, or improve, overall health.
- Exercise regularly. Walking is the simplest form of exercise, and the benefits are life-changing.
- Manage other health conditions that increase risk for PAD, such as high blood pressure, diabetes or high cholesterol.
- Practice good foot care. There is a strong connection between foot health and potential circulation problems. Certain symptoms in a patient’s foot may be an indicator of underlying vascular disease. This is especially common in diabetics. Having the patient check their feet every day is important, and especially for those with diabetes.
PAD is a chronic disease that requires lifelong care, and it affects many people in our community. You can learn more with free access to educational articles and videos on PAD provided by the board-certified, highly-specialized surgeons who make up my team at Peripheral Vascular Associates (PVA). We offer these resources to our community for free on our website at PVAsatx.com.
This article was written by Dr. Jeffrey Stein and featured in San Antonio Medicine Magazine, in their July 2022 issue. View the article here (hyperlink to http://bcms.org/SAM/2022/SAMJuly2022/mobile/index.html#p=32)
Jeffrey J. Stein, MD is a vascular surgeon at Peripheral Vascular Associates (PVA). He is a member of the Bexar County Medical Society.