Health & Fitness
PAD
By Anna Lamy | Hernando Today
Published: September 22, 2011
When people complain about leg pain, the discomfort is often diagnosed as a result of poor circulation.Published: September 22, 2011
Pain caused by poor circulation can be a result of atherosclerosis occurring in the legs and can be a sign of hardened or narrowing arteries to the heart or brain.
Arteries carry blood throughout the body. Atherosclerosis is a building up of plaque in the arteries. Plaque is composed of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.
When circulation in the arteries of the legs is severely reduced, pain can occur when walking or climbing stairs and can be a sign of peripheral artery disease. This symptom is called claudication.
PAD can also affect the heart, head, arms, kidneys and stomach, according to the National Heart Blood and Lung Institute.
Over time, the build up of plaque can harden and narrow the arteries, limiting the blood flow, depriving the body of oxygen.
Up to 12 million people in the U.S. suffer from PAD, according to the American Heart Association.
Other symptoms include foot or toe pain when at rest, and this can disturb sleep. Slow healing wounds on the feet – sometimes taking up to eight to 12 weeks to heal – can be a symptom of poor circulation caused by PAD.
PAD can also increase a person's risk to infections.
Gangrene, or tissue death, is caused as a result of severely blocked arteries and can lead to limb amputation.
Peripheral Vascular disease is a common circulation problem in which the blood vessels that carry blood to the legs become narrow or clogged, said Sheryl Clemente, Director of the Cardiology and Interventional Services at Brooksville Regional Hospital. "It is important for people to educate themselves about the risk factors of PAD and see their physician if they are experiencing any symptoms."
Vascular specialists who treat blood vessel diseases and conditions are often needed to treat severe cases of PAD.
C. John Ablan, a vascular and endovascular surgeon with Suncoast Surgical in Spring Hill, helped to bring a new treatment option for PAD to Brooksville and Spring Hill Regional Hospitals. The hospitals have implemented the EV3 TurboHawk plaque excision system for peripheral arteries requiring an atherectomy procedure.
"This system provides surgeons and their patients with a minimally invasive solution that can improve patient outcomes in the treatment of PAD," said Ablan.
"I use this system exclusively when atherectomy is needed," he added.
"Blockages are removed instead of just being pushed to the side of the artery or morselized with the potential of plaque traveling downstream and causing embolic injury," Ablan said. "Furthermore, the minimally invasive nature of the procedure means no incisions, shorter hospital stays and faster recovery times."
After performing approximately 1,000 interventions, in my opinion, this system is the best atherectomy device currently available," he added.
Older people often think leg pain is part of the normal aging process. It is important to discuss the symptoms with a physician to determine if testing is recommended.
Smoking increases the risk of developing PAD by four times, according to the NHBLI.
Other factors that increase the risk are a high fat or cholesterol diet, high blood pressure and high blood glucose (sugar) due to insulin resistance or diabetes.
PAD can increase a person's risk of developing coronary heart or artery disease, as well as heart attack, stroke, or transient ischemic attack, also called ministrokes.
A family history of heart disease, heart attacks, stroke or PAD also is a risk factor.
Your health care provider may request to have an ABI, ankle-brachial index, where a device using sound waves to scan the arteries for reduced blood circulation compares the blood pressure of the ankles to the arms.
Nonsurgical treatments include encouraging the patient to quit smoking, introducing methods to lower blood pressure and cholesterol, lowering blood glucose for diabetics, and being physically active on a supervised program. Follow a healthy diet plan to reduce the consumption of high fat (trans, saturated) and lowering sodium intake. Increasing consumption of fresh fruits and vegetables, while eating healthy, low-fat dairy products. For overweight or obese individuals, the NHLBI advises patients to work with a physician to develop an attainable and reasonable weight-loss plan.
Medicines can be prescribed to lower cholesterol, reduce high blood pressure, prevent blood clots and decrease leg pain when walking or climbing stairs.
Surgical options include atherectomy, angioplasty and stents, or bypass grafting.
Atherectomy is a procedure that removes the build up of plaque within the artery through using a catheter to insert a small cutting device, shaving and cutting the plaque. The plaque is collected in the cutting device nosecone, then safely removed from the body.
Angioplasty helps to restore blood flow to the narrowed or blocked artery with a catheter and a balloon, which is inserted and inflated in the affected area, which flattens the blockage on the artery wall. A stent may be inserted to help keep the artery open, the same as a heart stent.
Bypass grafting is when a vessel is harvested from another part of the body or a synthetic vessel and surgically bypasses the blocked area to restore blood flow; the same as with open heart bypass surgery.
It is strongly recommended, for those with leg or thigh pain, to discuss the symptoms with a health care provider, as it may be a caused by a serious condition.
--Courtesy of the Peripheral Artery Disease Coalition.