August 14, 2023

11 Frequently Asked Questions about PAD

Are you diagnosed with peripheral artery disease (PAD) and experiencing severe leg pain, numbness, and tingling in your fingers, ankles, and feet? Make sure to visit an interventional cardiology clinic and consult your interventional cardiologist immediately to seek answers and treatment for your condition. 

To gain a comprehensive understanding of the disease and determine your next steps, we have compiled a list of essential questions to discuss with your doctor during your initial consultation. By addressing these issues in depth, you can obtain essential information and guidance.

1. What is peripheral artery disease (PAD)?

Peripheral artery disease refers to the accumulation of plaque in the arteries, which can hinder proper blood flow to the legs. 

2. What are the risk factors for peripheral artery disease (PAD)?

Factors such as unhealthy eating, smoking, high cholesterol, high blood pressure, being overweight, having diabetes, and being advanced in age are known to increase the risk of developing PAD.

3. How common is PAD?

PAD is a common condition, with approximately 8 million individuals in the US currently affected by it. It has been observed that up to 20 percent of individuals above 60 years of age may experience the disease.

4. What are the symptoms of PAD? 

* Painful cramps in hips, calves, or thighs while engaging in physical activity and resolving on rest (Claudication)

*Leg hair may stop growing

*One foot may feel colder than the other.

*Persistent non-healing sores on the ankles, legs, or feet. 

5. How can I reduce my chances of developing PAD?

Engaging in physical activity, quitting smoking, and maintaining a healthy weight can lower the risk of developing diabetes, heart disease, and PAD. 

6. How is PAD diagnosed?

To diagnose PAD your doctor would first like to do a thorough physical examination in which might include looking for pulses in different parts of your limb.  The tests that your doctor may order for are:

  • Ankle: Brachial Index (ABI): in this test the doctor will measure the blood pressure in your arm and your leg with the help of a cuff and a special probe to compare them. An imbalance in their values may point towards PAD.
  • Ultrasound: Using special technique, like the Doppler ultrasound your doctor will be able to identify the vessel involved and the severity of the disease.
  • Coronary CTAby injecting a dye into your blood vessels during this procedure your doctor will be able to directly visualize the flow of blood through the arteries and identify the affected area.
  • Catheter angiographymore invasive than CT angiography, this procedure can also be used for treatment as well as diagnosis. A thin tube called a catheter is inserted into your artery in the groin and a dye is injected to visualize the artery. If required, the narrowing can be corrected simultaneously.

7.  What are the treatment options for PAD?

  • Cessation of cigarette smoking
  • Supervised exercise training for a minimum of 30-40 minutes, 3-5 times a week for at least 12 weeks, which has shown improvement in symptoms for patients with claudication
  • Controlling blood pressure with antihypertensive medications like ACE inhibitors
  • Using statins to maintain a normal lipid profile, as an abnormal profile increases the risk for PAD development
  • Prescribing anti-coagulant therapy such as aspirin or clopidogrel to reduce the likelihood of blood clot formation, which can narrow arteries
  • Cilostazol, a medication that dilates arteries and increases blood supply to the affected limb
  • Pentoxifylline, a medication that increases oxygen delivery to tissues, partially compensating for artery narrowing
  • Percutaneous Transluminal Angioplasty (PTA) is a minimally invasive procedure involving the use of a small catheter with a balloon to open narrowed arteries.
  • Bypass surgery

8. Will my quality of life be impacted after diagnosis of PAD?

By prioritizing a healthy lifestyle and implementing moderate modifications to your eating habits and physical activity, you could potentially prevent PAD progression. However, if you are diagnosed with PAD, effectively managing daily pain will likely be your primary obstacle until receiving treatment. It is crucial to remain vigilant about the condition of your legs and feet, as even minor injuries like cuts, bumps, or scrapes can result in long-lasting and harmful ulcers.

9. Do I need surgery for PAD?

Your doctor will assess whether surgery is necessary for your condition.  The leg bypass surgery involves creating a new path for the blood to flow around the affected area with the help of a graft. The graft can be a vessel from your body of it could be made from a synthetic material.

10. What are the potential complications of PAD?

If treatment for PAD is not sought, individuals can develop significant leg pain, severe foot or leg infection which can lead to amputation in severe cases.

11. What is the prognosis of PAD?

Individuals with PAD have a 15-30% 5-year mortality and about a 2-6-fold increase in chances of death due to coronary artery disease compared to individuals without PAD. Deterioration might occur in the remaining 20-30%, of which some will develop critical limb ischemia. Approximately 25-30% of patients with critical limb ischemia undergo amputation within a year.

Closing Remarks

After visiting an interventional cardiology clinic and undergoing a PAD diagnosis, the next step is to navigate through the challenging process of selecting the most suitable treatment. Your cardiologist or vascular surgeon should be entrusted as your primary source of guidance for this significant health issue. They have the expertise to create a tailored treatment plan that caters to your requirements, allowing you to regain mobility and lead the most fulfilling life possible.