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Peripheral Arterial Disease (PAD) and Amputation

 

Risk Factors


The buildup of plaque on the artery walls is called atherosclerosis, or hardening of the arteries. It causes the arteries to narrow or become blocked, which can reduce or block blood flow. When atherosclerosis affects the arteries of the heart, it is called coronary artery disease (CAD). CAD can cause a heart attack. If atherosclerosis is in the limbs, it is called peripheral arterial disease (PAD). It most commonly affects blood flow to the legs.  If PAD is present, it also is likely to be in the coronary arteries. Smoking, high cholesterol, obesity, diabetes and high blood pressure are all PAD risk factors.  Blocked blood flow can cause pain and numbness. It also can increase a person's chance of getting an infection, and it can make it difficult for the person's body to fight the infection. If severe enough, blocked blood flow can cause tissue death known as gangrene. PAD and diabetes are the leading cause of non-traumatic, lower-limb amputations.

Prevalence              

PAD is a disease that affects millions of Americans over age 50. PAD affects 8 to 12million Americans, and one in every five people over the age of 70 has the disease. It is a common, yet serious disease. Men are more likely to have symptoms of PAD, but both men and women can develop the disease. PAD can impair physical health and diminish the ability to walk.


Complications


In the advanced stages of PAD, blood flow to one or both legs can be completely or mostly blocked. This is known ascritical limb ischemia (CLI). A very severe blockage in the legs and feet means that the legs do not receive the oxygen or nutrition needed for cellular or tissue growth and repair. CLI may lead to painful leg or foot sores (ulcers), and it could eventually lead to gangrene. If this condition is left untreated, the foot or leg may need to be amputated.

PAD Warning Signs

• Fatigue, tiredness, cramping or pain in your legs, thighs or buttocks that always occurs when you walk but that goes away when you rest. This is called claudication.

• Foot or toe pain while idle that often disturbs your sleep.

• Skin wounds or ulcers on your feet or toes that are slow to heal (or that do not heal for 8 to 12 weeks). 

Many individuals with PAD do not experience typical leg symptoms, such as cramping, pain, or fatigue, so those at risk should undergo screening for PAD.

Diagnosis


A simple non-invasive test to determine if you have PAD can be performed in approximately 30 minutes right in our office.  The test is called an ankle-brachial index (ABI). It compares the blood pressure in your ankles with the blood pressure in your arm. If your ABI is abnormal, we will refer you to a vascular specialist with whom we closely work for further testing and possible treatment.  If you have any of the above warning signs, call one of our offices(Contact Us) to schedule an exam.