Q&A Topic: Your Limbs, Your Life: Peripheral Artery Disease

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Kenneth Goldstein, MD

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Q. What causes Peripheral Artery Disease (PAD)?

A. PAD often occurs when plaque deposits of fat, cholesterol, and other substances build up in the walls of the arteries. Over time, these deposits can cause atherosclerosis, a narrowing or complete blockage of the arteries. Think about a clogged shower drain. When there’s no place for the water to go, it drains slowly over time. If you continue to ignore the clog, you can expect more serious plumbing issues. The same is true with your arteries.

Q. What are common symptoms of PAD?

A. PAD symptoms often begin with leg pain and worsen over time. You may experience pain in your calf when you walk or exercise. The pain often stops when you’re still, but recurs with movement. You’re in pain because there’s not enough blood flow or oxygen in your limbs to keep up with the demands of the exercise. The pain may trigger limping. As symptoms get worse, you may even feel pain or numbness at rest. If you’re in pain, it’s important to talk to your doctor about your symptoms. It’s not uncommon for people to begin sleeping in a chair – where hanging legs bring relief as blood is forced down through the arteries in the limbs.

Q. Do those with PAD always experience pain in their limbs?

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A. No. In fact, up to 40 percent of people with PAD don’t have notable leg discomfort.And symptoms may mirror less serious complications, making PAD one of the most undiagnosed, misdiagnosed and mistreated conditions. Non-healing ulcers, ingrown toenails, thickened toenails, hair loss on feet, cold feet, or no pulse in feet are also symptoms.

Q. Is progression or the onset of PAD rapid?

A. Though progression isn’t rapid, severe PAD can cause tissue loss and gangrene, and can even be deadly. Regular screening for PAD is critical because the condition can be a marker for coronary artery disease and cerebrovascular disease, which could ultimately lead to a heart attack or stroke. As the population ages, PAD is more prevalent, it’s important that everyone over age 70 goes for annual screening.

Q. If I’m diagnosed with PAD, what are my options?

A. After a diagnosis of PAD, the goal of treatment is to manage your symptoms and stop the progression of the disease in order to reduce your risk for heart disease and stroke. You might accomplish these goals with lifestyle changes – quitting smoking, increasing exercise and eating a healthy diet rich in fruits, veggies and legumes – or you may need treatment. Treatment includes minimally- invasive techniques like balloon angioplasty, stent placement and atherectomy procedures to help keep the blood flowing in the arteries of the lower limbs. For severely blocked arteries, bypass surgery lets us bypass severely blocked blood vessels. This often requires a three-to-five-day hospital stay and some time in a rehabilitation facility.

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Learn More About Dr. Goldstein
Chief, Vascular Surgery
Northern Westchester Hospital

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