Putting the Breaks on PAD (Peripheral Artery Disease)
Exercise is hard work, and while there may be some truth to the old saying “no pain, no gain,” the pain of exercise shouldn’t linger — specifically cramping in your leg muscles — once you’ve quit working out or walking. If you experience painful muscle cramping in the legs that goes away shortly after you stop exercising, especially if you’re older, it could mean more than just being out of shape … you may be suffering from Peripheral Artery Disease (PAD).
Peripheral arteries are blood vessels leading to the kidney, stomach, arms, legs, and feet. PAD occurs when these arteries narrow or become hardened by a buildup of plaque (fatty deposits, cholesterol, or other substances). As a result, blood flow is restricted causing pain in the lower extremities.
According to the American Heart Association, PAD affects nearly 8 million Americans. Yet many do not know they have the condition as the symptoms are easily dismissed as the normal aches and pains of getting older, and are often not discussed with a physician. If left undiagnosed and untreated however, PAD can lead to serious health problems such as gangrene, amputation of limbs, heart attack, and stroke.
While PAD can be a debilitating disease, there are several treatment options for those who suffer from it.
“Lifestyle changes, including quitting tobacco use, an increase in physical activity, eating a healthy diet, and addressing other health concerns such as diabetes and high blood pressure are the first steps to reducing the effects of Peripheral Artery Disease,” said Tarkten A. Pharr, M.D., a board certified vascular surgeon with Carolina Surgical Care.
Even though it may be painful at first, Dr. Pharr said physical activity is the key to improving overall health. (Always check with your physician before you begin any exercise program.)
“It’s almost a training program,” he said. “Think of running cross country, or training for a marathon. No one starts off running five miles a day; start small, work in achievable increments, and gradually increase your activity. Before you know it, you’ll be walking or exercising more than you thought you could, and you’re on your way to better vascular health.”
If lifestyle changes aren’t enough, treatment may include medication and/or surgery — whether it’s a simple option such as peripheral angioplasty, or a more intensive surgical procedure like peripheral bypass. These and a range of other procedures on the vascular system can be done in Albemarle Hospital’s specialized Vascular Intervention Suite.
The Vascular Intervention Suite, located inside the hospital’s Diagnostic Imaging department, includes a Siemens Digital Flat Panel Angiography System (DFA) that allows Dr. Pharr to see clear, digital images of veins and arteries, manipulate and store the images, and transmit them to remote locations such as his office, or a major medical center for consultation.
Peripheral angioplasty is a minimally invasive procedure in which Dr. Pharr makes a small incision in the thigh, and inserts a catheter with a tiny balloon into the leg’s main artery. At the site of the blockage, Dr. Pharr inflates the balloon, and plaque is pushed (or flattened) against the artery wall. Once the balloon is deflated, and the catheter is removed, the result is a freer flow of blood. A stent (a tiny wire mesh cylinder) may also be inserted into the blocked artery to force the artery open and keep it open.
“These procedures can be an easier solution for patients (versus invasive surgery),” said Dr. Pharr. “They’re typically back to normal activities in a few days. There’s little downtime, and relatively little pain.”
In cases where the artery is completely blocked and angioplasty and/or stenting are not an option, surgery may be required. Peripheral bypass surgery involves using another vein from near the blocked artery or a synthetic vein to bypass, or reroute, blood around the clogged artery. This procedure works the same as the more familiar coronary bypass surgery for blocked arteries around the heart.
The procedure is typically very successful in terms of increasing blood flow around the blockage. Following this surgery, however, the patient usually requires five to seven days of recuperation before they resume limited activities.
“The ongoing success of any treatment for PAD depends greatly on the patient. They must commit to a healthy lifestyle afterwards,” said Dr. Pharr. “Incorporating exercise into their daily routine, eating a proper diet, quitting smoking, and treating any other health conditions they may have are essential. Every individual can positively affect the health of their vascular system.”
