Phone: (540) 654-9118

10401 Spotsylvania Avenue
Suite 203
Fredericksburg, VA 22408

Office Hours:

8 am - 5 pm, Mon. - Fri.

Peripheral Arterial Disease - Details

Peripheral Arterial Disease (PAD)
Evaluation and Treatment

Hardening of the Arteries is a Red Flag for Vascular Disease
Including Heart Attack and Stroke

Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a very common condition affecting 12-20 percent of Americans age 65 and older. PAD develops most commonly as a result of atherosclerosis, or "hardening of the arteries," which occurs when cholesterol and scar tissue build up, forming a substance called plaque inside the arteries that narrows and clogs the arteries. This is a very serious condition. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking, and eventually gangrene and amputation.

Peripheral Arterial Disease Facts

Because atherosclerosis is a systemic disease, people with PAD are likely to have blocked arteries in other areas of the body. Thus, people with PAD are at increased risk for heart disease, aortic aneurysms and stroke. PAD is also a marker for diabetes, hypertension and other conditions. This is a major public health issue and the Society of Interventional Radiology recommends greater screening efforts through the use of the ankle brachial index (ABI) test. This simple, painless test compares the blood pressure in the legs to the blood pressure in the arms to determine how well the blood is flowing and if further tests are needed. Each September, during Peripheral Vascular Disease Month, interventional radiologists participate in Legs For Life, a nationwide screening program sponsored by the Society of Interventional Radiology.

Symptoms of PAD

The most common symptom of PAD is called claudication, which is leg pain that occurs when walking or exercising and disappears when the person stops the activity.
Other symptoms of PAD include: numbness and tingling in the lower legs and feet, cold lower legs and feet, and ulcers or sores on the legs or feet that don't heal.

Get tested if you:

Are over age 50
Have a family history of vascular disease, such as PAD, aneurysm, heart attack or stroke
Have high cholesterol or high lipid blood test
Have diabetes
Have ever smoked or smoke now
Are overweight
Have an inactive lifestyle
Have a personal history of high blood pressure, heart disease, or other vascular disease
Have trouble walking that involves cramping or tiredness in the muscle with walking or exercising, which is relieved by resting
Have pain in the legs or feet that awakens you at night

Diagnostic Tests

The most common test for PAD is the ankle-brachial index (ABI).

The ABI is a simple, painless test to help our physician determine if you have PAD. The blood pressure in your arms and ankles is checked using a regular blood pressure cuff and a special ultrasound stethoscope called a Doppler. The pressure in your ankle is compared to the pressure in your arm to determine how well your blood is flowing and whether further tests are needed.

EndovascularTreatments: Angioplasty and Stenting

Using imaging for guidance, a catheter is threaded through the femoral artery in the groin, to the blocked artery in the legs. Then a balloon is inflated to open the blood vessel where it is narrowed or blocked. In some cases this is then held open with a stent, a tiny metal cylinder. This is a minimally invasive treatment that does not require major surgery, just a nick in the skin the size of a pencil tip.

Early randomized trials have shown this procedure to be as effective as surgery for many arterial occlusions, and in the past five to seven years, a very large clinical experience in centers throughout the world has shown that stenting and angioplasty are preferred as a first-line treatment for more and more processes throughout the body.

Other surgical procedures for treating PAD include relatively new techniques including laser atherectomy, cryoplasty and rotational atherectomy. Your physician can discuss the most appropriate treatment options for your particular condition.

Surgical Treatments: Bypass and Other Procedures

Sources: Society for Vascular Surgery, Virginia Interventional and Vascular Associates,

Surgical bypass remains a front-line treatment for PAD. You may be familiar with bypass surgery on heart arteries, but vascular surgeons also perform bypasses to treat leg artery disease, arm artery disease and blockages involving blood vessels elsewhere in the body.

The procedure creates a detour, or bypass, around the section of the artery that is blocked. Your vascular surgeon creates a new pathway for blood flow using a graft. This can be a portion of one of your veins or a manufactured synthetic tube that your surgeon connects above and below a blockage to allow blood to flow around the blockage.

FOR MORE INFORMATION CONTACT:

Virginia Interventional and Vascular Associates (VIVA)
1201B Sam Perry Blvd
Suite 265
Fredericksburg, Virginia 22401
(Next to Mary Washington Hospital)
Phone: (540) 654-9118
Office Hours: 8 am to 5 pm Monday - Friday
Email: info@vivassociates.com
Web site: www.vivassociates.com

Virginia Interventional and Vascular Associates