Risk factors for PAD:
The following are typical risk factors that contribute to PAD:
• Smoking
• Diabetes
• Heart disease, such as coronary artery disease (CAD)
• Being age 60 or older
• High blood pressure
• High cholesterol, a high-fat diet, or both

Symptoms of PAD:
If you experience cramping or aching while you are walking in your buttocks, thighs, calves and when you stop those symptoms go away you may have PAD. This pain or uncomfortable sensation is called claudication. These same symptoms may become worsened when going up a flight of stairs. If someone is prone to cardiovascular disease it may not be limited to any one particular part of the bodies circulation system. It may affect arteries that supply blood to anywhere in the body and artery disease may affect more than one area of the body’s circulation.

Testing for PAD:
• Ankle-brachial index or ABI compares blood pressure in your ankle with the pressure in your arm. Based on the results, your doctor may diagnose PAD.
• Doppler ultrasound looks at the blood flowing through your arteries. It can show changes in blood flow due to artery narrowing or blockage.
• Imaging Tests –
1. Arteriography is an x-ray test that pinpoint where the artery is narrowed or blocked. Before the procedure you are given medication to make you comfortable. A long thin tube or catheter is then inserted into the artery in the groin. The catheter is threaded into the affected artery at which time a contrast dye fills the artery to demonstrate the blood flow very clearly while x-ray pictures are recorded. This test is called an arteriogram.
2. CT arteriography uses computer-generated x-rays to provide detailed images of blood flow in the arteries.
3. MR arteriography uses a strong magnet and radio waves to produce images of blood flow in the arteries.
Risks and possible complications of Arteriography are:
• Bleeding from the catheter insertion site
• An allergic reaction to the contrast dye
• Small blood clots
• Artery damage
• Kidney problems

Treatment options:
• Lifestyle changes; stop smoking, exercise daily, eat low-fat foods
• Endovascular Procedures;
Angioplasty - A balloon-tipped catheter is inserted into the artery and threaded to the narrowing or blockage. The balloon is inflated and deflated several times. This presses the plaque against the artery walls. Once the artery is open, the balloon is deflated and removed. Blood flows freely through the widened channel. Stenting – A collapsed stent is mounted onto a balloon catheter and guided across the blockage. The balloon is inflated to open the stent, which locks into place inside the artery. The balloon is deflated and removed. The stent remains in place, holding the artery open.
• These can be done through small punctures rather than full incisions and the recovery is often quicker, and complications tend to be fewer. Both endovascular procedures use catheters or thin tubes to reach blockages in your arteries.
• Bypass Surgery – open surgery may be the only option for longer or more severe blockages. This treatment uses a bypass graft to reroute blood around a blocked artery in the abdomen or leg. The damaged section of the artery is not removed during this procedure.

While you recover you will need to lay flat right after the procedure. And you may be asked not to blend your leg for 2 to 6 hours. The blood flow in your legs will be closely monitored during this time. Most people are able to go home the same day. Once home, take any medications as directed. Follow all your discharge instructions for the best recovery.

Dr. Jeff Taylor is trained and performs Endovascular Procedures as mentioned above. He is board certifies as an interventional cardiologist and performs the same procedures on the coronary arteries when they are blocked by performing Angioplasty and Stent placement as necessary.