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By Jaafer Golzar, M.D., F.A.C.C. F.S.C.A.I.,
Interventional Cardiologist, MidAmerica Cardiovascular Consultants
Peripheral arterial disease (PAD) consists of blockages in the arteries that supply blood to the legs. These arteries can fill with cholesterol plaque and significantly decrease blood flow to the legs. Eight to twelve million Americans are living with this condition. Patients with PAD often mistake pain in the legs for other conditions such as arthritis. This may lead to improper diagnosis and treatment. Initially, there may be no symptoms associated with PAD. Over time, a symptom known as claudication can develop. Claudication consists of pain or numbness in the buttocks, thighs or calves while walking and resolves after resting for several minutes. In advanced cases, peripheral arterial disease can prevent adequate blood supply from reaching the legs and can lead to ulcers, gangrene and amputation.
Peripheral arterial disease is caused by the same risk factors that lead to blockages in the arteries that supply the heart and brain. These risk factors include: advanced age, diabetes, high cholesterol, male gender, high blood pressure, high cholesterol and tobacco use.
In my most recent research published in the June 2007 issue of the Journal of Interventional Cardiology, I describe the most cutting-edge treatment for PAD. The good news is we have made significant improvements in the diagnosis and treatment of PAD over the past few years. Diagnosis can be made with a 64-slice CT scanner, which can create breath-taking, 3-D images of arteries in a matter of seconds. We can treat most patients through a tiny incision in the groin using x-ray to find and open the blockage.
Treatment for PAD has two major goals. The first is to stop the progression of atherosclerosis throughout your body and to reduce your risk of heart attack and stroke. The second is to manage symptoms, such as leg pain, so that you can resume physical activities.
You can often successfully treat peripheral arterial disease with exercise, with a healthy diet and, most important, by quitting smoking if you smoke. Early diagnosis and treatment are important to stop the progression of peripheral arterial disease and improve your chances on reducing your risk of heart disease and stroke.
Cardiovascular specialists (physicians that treat blockages in the arteries of the heart) use a similar technology to open blockages in the legs. Under local anesthesia, an incision the size of an eraser on a pencil is made in the groin. Through this incision, devices such as balloons, stents, lasers, diamond tipped drills and atherectomy catheters are used to open blockages in the legs. Atherectomy using a Foxhollow Silverhawk catheter shaves the plaque from within the artery and allows us to remove the cholesterol build-up from the body. The most cutting-edge treatment of PAD is usually an outpatient procedure. Most patients go home the day of the procedure and return to their normal activity with three days.
People with peripheral arterial disease, especially those who also have diabetes, are at risk of poor healing of sores on the lower legs and feet. Poor blood circulation can lengthen or prevent proper healing and increases the risk for infection. Follow this advice to care for your feet:
- Wash your feet daily and moisturize them well and often to prevent cracks that can lead to infection.
- Wear well-fitting shoes and thick, dry socks.
- Promptly treat any fungal infections of the feet, such as athlete's foot.
- Take care when trimming your nails.
- Avoid walking barefoot.
- See your doctor at the first sign of a sore or injury to your skin.
Talk to your family doctor or cardiovascular specialist if you or someone you know may be at risk for peripheral arterial disease.
Dr Golzar has offices in Oak Lawn, Illinois and Chicago, Illinois. If you would like to seek the advice of Dr Golzar or another one of our cardiovascular specialists, contact MidAmerica Cardiovascular Consultants in the southwest suburbs of Chicago at 708-636-7575.
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