What is peripheral arterial disease?
Peripheral arterial disease (PAD) damages your arteries, which are blood vessels that deliver blood from the heart throughout the body. Peripheral arterial disease, which occurs in various forms, is present when the arteries to your arms or legs narrow or become clogged. This most often results from hardening of your arteries or atherosclerosis. In the lower extremities, ischemia can cause claudication (a term used to refer to impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest) in peripheral artery disease (PAD) or may cause critical limb ischemia (CLI) in severe cases.
On this page
- Ankle brachial index
- Critical limb ischemia
The most common types of PAD include blood clots or atherosclerosis, a disease in which plaque, a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood, builds up inside your arteries. The plaque blocks blood flow and prevents oxygen from reaching tissue. This can cause pain, sores, or even dead tissue that can lead to strokes and heart attacks.
What are the symptoms of peripheral arterial disease?
Some people experience pain or heaviness in their legs while walking, which prevents them from enjoying their lives. You may have PAD if you experience the following during activity:
- Aching, throbbing legs
- Pain and cramping
- Discolored skin
You may be more likely to have PAD if (among other factors), you have High cholesterol, High blood pressure, diabetes or a history of smoking. An interventional radiologist can help determine if you have PAD through a simple test called an ankle brachial index test, or ABI, that compares the blood pressure in the upper and lower limbs or an examination using imaging techniques such as ultrasound, CT and MRI.
How do IRs treat peripheral arterial disease?
If lifestyle changes aren’t enough to treat your PAD, you might benefit from a minimally invasive interventional radiology treatment. In most cases, the IR will make a small incision in your groin and, using X-rays or other imaging to guide him, thread a very thin catheter through your blood vessels to the blockage or narrowed artery. Depending on where the blockage is and how it looks, it may be treated it in several ways.
Thrombolysis: Thrombolysis, which is usually enacted in an emergency because the body has not had enough time to respond by growing new blood vessels to bypass the blockage, is a treatment that delivers medication slowly, over 12-24 hours, to a blood clot through a thin tube that is inserted next to or within the clot. You’ll be hospitalized during the treatment and will be watched by nurses and doctors in the intensive care unit. Often, the clots will dissolve but the artery will still be narrowed, and additional treatments may be required.
Thrombectomy: When a blood clot suddenly blocks blood flow, a treatment known as a thrombectomy will remove the clot from the body using various medical tools that can draw out, pull out, or vaporize the clot.
Angioplasty: Angioplasty uses inflatable devices called balloons to open up narrowed arteries. Various types of balloons are used in different situations, including balloons that stretch arteries open, metal-edged balloons that cut and break up calcium deposits, and drug-coated balloons that can prevent scarring and future narrowing of the artery. During angioplasty, the interventional radiologist guides a catheter with a tiny balloon tip through the blood vessels into the blockage. The balloon is inflated to widen the artery, which restores blood flow.
Stenting: Sometimes, following balloon angioplasty, the doctor will place a stent (a tiny mesh tube) in the artery to help keep it open. Those who receive stents will also need to be on clot-preventing medications to reduce the chance of clots forming inside the stent.
What can I expect during treatment?
Once the treatment is completed, the IR removes the catheter and applies pressure to the tiny incision in your groin to allow it to heal. You will then lie flat on your back for several hours. Usually, you will be able to go home the same day, but there is a small chance you will be observed overnight and discharged in the morning. During a period of regular follow-up appointments, which can include ultrasound or other imaging tests, your IR will monitor your progress after the therapy.
Critical limb ischemia
Ischemia is a serious condition in which there is inadequate blood flow and oxygen to a specific part of the body, generally caused by a narrowing or blockage of an artery. Critical limb ischemia, or CLI, results in severe pain (often at rest) or tissue loss, such as a non-healing sore or even gangrene, related to peripheral artery disease. If the tissue of the limb has been affected; this requires immediate attention.
Critical limb ischemia is serious and will not improve on its own. An interventional radiologist will perform angiography help determine if revascularization (opening up) the blocked artery will help your condition. The poor prognosis demands a multidisciplinary approach involving interventional radiologists who are specialists in endovascular revascularization, surgeons, podiatrists, wound care experts, and other specialties to maximize patient outcomes.
Disclaimer: This information is provided as a public service. IYA assumes no liability, legal, financial or otherwise for the accuracy of this information or the manner in which it is used. This information is being provided for informational purposes only and should not be used to replace professional medical advice from your physician or qualified health care professional.