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Peripheral Artery Disease

Vascular services are often used to diagnose and repair blood vessel conditions in your legs, arms, and feet. A common blood vessel condition in your legs, arms, and feet is peripheral artery disease (PAD).

What is PAD?
Peripheral artery disease (PAD) is a condition in which plaque builds up along the inside walls of the arteries in your legs and arms. This plaque buildup limits blood flow to your muscles, and your arteries harden and narrow. People with PAD are at a much greater risk of developing coronary artery disease, heart attack, and stroke.

What are some symptoms of PAD?
Some common symptoms of PAD include:

  • Leg pain that occurs when walking or exercising but disappears at rest
  • Wounds on your feet or toes that do not heal well or are slow to heal
  • Coldness in your lower legs
  • Shiny skin on your legs
  • Hair loss on your legs
  • Decreased pulse in your feet

What causes PAD?
PAD is caused by plaque that has built up along the inside walls of your arteries. The plaque buildup narrows your arteries and limits blood flow to every part of your body. This plaque buildup, a condition called atherosclerosis, usually happens at the same time throughout your body. Atherosclerosis is also a common cause of heart attack and stroke.

What are the risk factors for PAD?
Since atherosclerosis also plays a role in the development of heart attack and stroke, the risk factors for PAD are the same as the risk factors for heart attack and stroke:

  • Diabetes
  • High cholesterol
  • High blood pressure
  • Smoking
  • Lack of physical activity
  • Personal history of heart disease, heart attack, or stroke

How is PAD diagnosed?
Your physician may diagnose PAD in a variety of ways:

  • Doppler and ultrasound (duplex) imaging: a test that creates images of your arteries using sound waves. The test measures the blood flow in an artery to identify any blockages.
  • Ankle-brachial index (ABI): a measurement of your blood pressure at your ankle and then at your upper arm using an ultrasound probe. You have PAD if the blood pressure at your ankle is significantly weaker than the blood pressure in your upper arm.
  • Angiography: a minimally invasive imaging test that uses X-ray and contrast dye to create images of the blood flow in an artery to help identify the exaction location of a blockage.
  • Magnetic resonance angiography (MRA): an imaging test that uses radio waves, a magnet, and often contrast dye to create images of your arteries.

How is PAD treated?
To prevent PAD from progressing, your doctor may recommend that you make the following lifestyle changes:

  • Keep your cholesterol and blood pressure at healthy levels
  • Eat a healthy diet
  • Quit smoking
  • Manage diabetes
  • Exercise regularly

You may be prescribed medication to alleviate some of the symptoms associated with PAD.

Your doctor may also recommend that you undergo a procedure to improve blood flow in your arteries. Some of those procedures include:

  • Angioplasty: a procedure in which a thin, flexible tube (catheter) is inserted through an artery in your groin or arm and guided into the artery that is narrowed. A small balloon on the end of the tube is inflated within your artery. The inflated balloon flattens the plaque against the walls of your artery, widening the artery and helping to restore blood flow.
  • Atherectomy: a procedure in which a small blade, inserted through a catheter, is used to shave away plaque that has built up along an arterial wall. Shaving the plaque away helps to restore blood flow.
  • Stenting: a procedure in which a tiny mesh-metal tube (stent) is placed into the narrowed area of your artery to keep it open. The stent remains permanently in your artery.

Treatments for PAD
Orbital atherectomy is a procedure in which a small, diamond-coated crown is used to remove even the toughest kind of plaque without damaging your arteries. This procedure is designed to optimize treatment in the arteries of the lower leg or below the knee.

Sacred Heart HealthCare System uses the Diamondback 360™ Orbital Atherectomy System (OAS) for removing plaque blockages in the legs and restoring blood flow.

The device differs from existing atherectomy technologies in its ability to remove hard, calcified plaque, in addition to other common kinds of plaque, using a unique “orbiting” action that preserves the healthy tissue of the arterial wall.

Drug Eluding Balloons
The Lutonix DCB is a percutaneous transluminal angioplasty (PTA) catheter. The product has a balloon that is used to re-open the artery. The balloon is coated on its outer surface with the drug paclitaxel, which may help to prevent recurrent narrowing of arteries (restenosis) after the procedure. During the procedure, the artery is first partially opened with a traditional angioplasty balloon, without a drug coating. The Lutonix DCB is then used to fully open the narrowed portion of the artery and apply the drug to the artery wall. The Lutonix DCB may be used in arteries located in the thigh or the knee.

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