Posts Tagged ‘PAD’

What Are the Symptoms of Peripheral Artery Disease?

As we pointed out in our previous Peripheral Artery Disease (PAD) post, nearly half of people with this condition are unaware of their diagnosis because they experience no symptoms or are unaware that their complaints are due to PAD.  PAD can develop slowly over one’s lifetime so that symptoms may not present until arteries are severely blocked.

One of the major symptoms associated with this disease is referred to as claudication, which involves pain or cramping in the arms or legs during exercise or merely walking.  Every patient is different and some may experience it as heaviness, burning, or numbness.  The pain typically diminishes with rest, and may be severe, depending on the blockage of the artery.  When involving the legs, this symptom occurs most commonly in the calf muscle, but can often involve the buttocks or thighs.  Claudication may occur in one or both legs.  Discomfort is often worse when walking up stairs or uphill.

In severe cases, PAD can also cause symptoms that involve intense pain at rest. This is due to insufficient amounts of blood or oxygen reaching the legs even in the resting state.  Patients may find that they have severe pain at night relieved by hanging the foot down from the bed.

Other symptoms of PAD include:

–       Numbness of the limbs/extremities

–       Sensation of coldness in the legs or feet

–       Ulcers in the toes

–       Redness or discoloration of the skin

–       Foot and toe sore that will not heal

–       Loss of hair on the legs and changes in nail growth

Our next post will discuss which patients and/or candidates should be treated for PAD. If you have questions on the symptoms of PAD, or about this condition in general, please be sure to let me know in the comments.

About Chandan Devireddy, MD:

Dr. Devireddy specializes in Interventional Cardiology and Cardiovascular Medicine, and has been practicing with Emory since 2005. He actively participates in the Interventional Cardiology research department, which has been a significant enroller in several multi-center clinical trials. His individual research interests include acute coronary syndromes, novel coronary and peripheral technology, and medical and interventional treatment of peripheral vascular diseases.

Minimally Invasive Treatment for Peripheral Artery Disease: Dave Kirschner’s Story

In 2008, Dave Kirschner chose to retire from a successful 50-year career in the radio business. For years, CNN Radio listeners listened to him as he brought them up to speed on current events. Now, Kirschner spends his time working around the house, staying in touch with industry friends, and working out on the treadmill several times a week. However, when he began to notice a recurring pain shooting down the back of his right leg during exercise, he was concerned.

At first, Kirschner thought that he might have a pulled muscle, so he attempted to ease the pain with stretching, massage, and over-the-counter remedies. When nothing worked, he realized that he may have a deeper problem, and he called his internal medicine doctor.

His doctor conducted a test called an Ankle Brachial Pressure Index, or ABI—which revealed that Kirschner was suffering from peripheral artery disease (PAD).  As we’ve described in previous blog posts, PAD develops when arteries become clogged with plaque and fatty deposits that limit the flow of blood to extremities, especially the legs.

The major symptom that Kirschner was experiencing is called intermittent claudication—a pain that occurs during periods of exercise, such as walking or climbing the stairs. When we exercise our muscles require more blood flow—if there is blockage in the blood vessels, the muscles don’t receive enough blood, which causes intermittent claudication.

The first Atlanta cardiology group that Kirschner visited recommended that he have a stent inserted into his leg to unblock the artery. However, this option wasn’t appealing to him—he’d had cardiac bypass surgery in the past and wanted to avoid invasive surgery if at all possible.

Kirschner proceeded to search for other alternatives for PAD treatment—he researched the Internet and asked several of his trusted friends for advice. He even considered traveling out-of-state to find a facility that would offer what he was looking for. Finally, he spoke with a podiatrist friend, who recommended that he contact me at Emory.

After examining Mr. Kirschner, we reviewed his options and decided that a minimally invasive outpatient procedure would be the best way to treat his condition. We used a recently developed device to shave away the plaque in his arteries—the device deploys a tiny rotating blade on the tip of a catheter to remove plaque from the arterial wall. This procedure has been extremely successful in helping patients to prevent blood flow problems that could potentially result in something as serious as amputation.

The device doesn’t stretch the blood vessel wall, unlike the use of stents. It is used to treat calcified and non-calcified lesions of any length. Further, it is minimally invasive and doesn’t require that we open up the leg.

Kirschner’s procedure took less than two hours. When he asked me how long I thought it would be before he could go back to working out, he was shocked when I replied, “How about tomorrow?” He left our office the same day that he went in, with only a tiny incision at the top of his leg, covered by a band-aid.

Today, Kirschner can hit the gym and exercise with no pain. His workout regimen consists of hour-long walks, which he enjoys without any problems. We’re thrilled that we were able to treat his condition with our innovative technology, and we look forward to achieving the same results with future patients suffering from PAD.

About Gregory Robertson, MD:

Dr. Robertson specializes in Cardiology and Internal Medicine, and is an Assistant Professor of Medicine at Emory. Some of his areas of clinical interest include atherosclerosis, cardiac catheterization, cardiovascular disease, valve disease, and peripheral artery disease. Dr. Robertson holds an organizational leadership membership at The American College of Cardiology, and has contributed to multiple publications in his field.

Examining Peripheral Artery Disease

Khusrow Niazi, M.D.

Peripheral Artery Disease (PAD) is defined as diseases of the blood vessels outside of the heart and brain. PAD is a term used interchangeably with Peripheral Vascular Disease, or PVD, and typically involves the narrowing of vessels that transports blood to the arms and legs.

Perhaps the most challenging aspect of this disease is the fact that it often carries no symptoms. At least half of people who suffer from it have no signs or indications. Unfortunately, up to 60% of an artery can be blocked by the time the condition is discovered.

Eight to 12 million people in the US suffer from PAD, and are at increased risk for heart disease, aortic aneurysms, and stroke. Additionally, PAD can be a precursor to diabetes, hypertension, and various other conditions.

Karthik Kasirajan, M.D.

PAD is usually accompanied by atherosclerosis, a process in which plaques, hard cholesterol material, and fatty substances collect along the interior walls of the arteries. As the material hardens, it ultimately causes the arteries to narrow, which can cause diseases in other organs throughout the body.

Atherosclerosis is a systemic disease; in other words—it affects the entire body. Therefore, it’s common for people with PAD to have blocked arteries in other areas of the body. Those who suffer from PAD are at increased risk of heart disease, aortic aneurysms, and stroke.

At Emory, medical, surgical and catheter-based treatment of PAD is a combined effort from the Emory Heart & Vascular Center, the Division of Vascular Surgery and Endovascular Therapy, and Interventional Radiology.

In our next series of blog posts, we’ll examine other aspects of PAD, including symptoms, prime candidates for treatment, treatment options, and patient stories.

Do you have questions regarding Peripheral Artery Disease? If so, please let us know in the comments section—we’re happy to address them.

About Khusrow Niazi, MD:

Dr. Niazi specializes in interventional cardiology, carotid artery disease, peripheral artery disease and venous disease of the legs. He has been practicing at Emory since 2003. He has been involved in many trials in treating blockages in the carotid arteries and leg arteries with less invasive options. Dr. Niazi is involved in trials focused on the removal of plaque from the leg arteries with less invasive methods.

About Karthik Kasirajan, MD:

Dr. Kasirajan specializes in surgery and vascular surgery, and has been practicing at Emory since 2003. Several of his areas of interest include peripheral arterial disease, endovascular surgery, abdominal and aortic aneurysm, vascular surgery, thrombotic disease, and stroke. Dr. Kasirajan holds many organizational leadership memberships, including the European Society for Vascular Surgery, International College of Surgeons, and the Peripheral Vascular Surgical Society, and is widely published in publications such as the Journal of Endovascular Therapy and the Journal of Vascular Surgery.