Peripheral artery disease (PAD) is the term describing a progressive blockage of arteries resulting in a decrease of blood and oxygen to tissues. PAD affects over 10 million individuals in the U.S., however 75% of symptomatic patients never get any treatment. The result of untreated end stage PAD is development of gangrene which often leads to amputation.
The most significant risk factors for developing PAD are smoking, diabetes, high cholesterol, and high blood pressure. In the early stages of PAD treatment is medical in nature with lifestyle modification -- including smoking cessation, tight control diabetes and taking medications to control cholesterol levels, and an exercise regimen. More advanced symptomatic PAD may require procedures to re-establish blood flow to the extremities. These procedures may include angiography with balloon angioplasty, stenting, or even use of a laser or "roto-rooter" device to open previously blocked arteries. Open bypass surgery of the legs may also be required restore blood flow across blocked arteries.
The treatment of PAD must be individualized. Not everybody with PAD needs surgery. As a rule there are three sets of symptoms which must be treated:
1 - Lifestyle limiting claudication - recurrent and reproducible pain in the legs occurring with walking at very short distances. The pain is relieved with rest. Symptoms are significant enough to adversely affect the daily activities and lifestyle of the patient.
2 - Tissue loss as defined by the development of ulcers in the legs/feet and even gangrene.
3 - Rest pain - Pain in the legs/feet occurring at rest due to severely diminished blood flow to the affected extremity.
Some patients who require treatment of their PAD are candidates for minimally invasive procedures. This may include use of the Silverhawk "roto-rooter" device which removes the plaque from within the artery. Another very good device is the Spectranetics laser, which is used to burn through blockages and create a channel for blood to flow through and across diseased or completely blocked arteries.
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