Peripheral Arterial Disease
Treating PAD with Interventional Radiology
The procedures that our doctors use to treat PAD are part of a medical specialty called Interventional Radiology (IR). This refers to the use of radiological image guidance to precisely target and treat a range of medical conditions and diseases.
Interventional radiologists are doctors who are specially trained to do minimally invasive vascular procedures, such as angioplasty and embolization, to treat a variety of conditions. Because many IR procedures start with passing a needle through the skin to the target, it's often called "pinhole surgery."
When treating PAD, each patient is evaluated, and the treatment approach is individualized for the patient's circumstances. The next section discusses three treatment options for PAD.
Minimally Invasive IR Treatments for PAD
Peripheral Vascular Disease (PVD) is a peripheral circulation disorder that affect blood vessels outside the heart and brain. PVD that develops only in the arteries is called Peripheral Arterial Disease (PAD). 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. This is a very serious condition. The clogged arteries cause decreased blood flow to the arms, or more commonly, the legs. This can result in pain when walking and eventually gangrene and/or amputation.
Signs and Symptoms of PAD & PVD:
The most common symptom of PAD and arterial insufficiency is called intermittent claudication, which is painful cramping in the leg or hip that occurs when walking or exercising and typically disappears when the person stops the activity.
Other symptoms include: numbness, tingling and weakness in the lower legs and feet, burning or aching pain in feet or toes when resting, sore or wound on the leg or foot that won’t heal or is slow to heal, cold legs or feet, color changes in skin of legs or feet, hair loss on legs, pain in the legs or feet that wakes you up at night or pain at rest.
All of these symptoms can be indicative of poor circulation in lower extremity arteries.
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PVD that develops in the deep veins in the body is usually caused from claudication and is called Deep Vein Thrombosis (DVT).
The causes of Peripheral Artery Disease
Peripheral artery disease is caused by a blockage in the arteries of the leg or arm. Our arteries are like hollow tubes through which blood flows. These tubes are smooth and stretchy.
As a result of predisposed risk factors and lifestyle choices, fatty deposits can attach themselves to the inside walls of blood vessels. Once fatty deposits start to stick, they build up. The body attempts to heal itself from the fatty buildup by making the vessel walls sticky.
This healing response allows other substances in the bloodstream, including calcium, proteins, and inflammatory cells, to become stuck. Together with the fatty deposits, this debris forms a plaque that narrows the artery.
Angioplasty:
Uses imaging guidance to insert a catheter (thin tube) into a blocked or narrowed artery. The catheter has a tiny balloon on its tip that is inflated to push plaque against the artery's walls to widen the path for blood flow.
Stenting:
Uses imaging guidance to direct a balloon catheter, and then a stent, to the site of the blockage. The balloon is inflated to open the blockage, and then deflated and taken out, leaving the stent in place to keep the artery open.
Atherectomy:
Uses imaging guidance and a catheter specially designed to remove plaque and collect it in a chamber in the tip. This allows removal of the plaque as the device is removed from the artery. Atherectomy may be used alone or in combination with balloon angioplasty to facilitate the placement of stents.
