PERIPHERAL ARTERIAL DISEASE (PAD)
CRITICAL LIMB ISCHEMIA (CLI)
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PERIPHERAL ARTERIAL DISEASE (PAD)
You don’t catch peripheral arterial disease (PAD) like you do a cold or a virus. Most often, PAD progressively develops over a long period of time in middle-aged or elderly people with other underlying medical conditions such hypertension, diabetes, cardiovascular disease, kidney failure or poor dietary habits. Initially, PAD may be ignored or masked by a sedentary lifestyle or confounded with pain from spinal stenosis, disc herniation, peripheral neuropathy or other orthopedic problems affecting the lower extremities. PAD is usually bilateral (both legs). symptoms often affect one side more than the other so that you may not realize that the other side is diseased as well. You may notice the same symptoms on your good side, once the bad side is fixed.
CLAUDICATION
Early PAD may present as cramping in the calf and/or thigh while climbing stairs or walking. This is known as claudication. Cramping is due to poor circulation (clogged arteries), unable to deliver sufficient oxygen to the muscles resulting in a buildup of lactate. Claudication varies in severity and is measured by your ability to walk (number of blocks or flights of stairs). Claudication usually resolves when you stop to rest and recurs when you walk again. You may learn to live with these limitations or show improvement with regular supervised walking exercise and medication. However, if you are physically active and are bothered by these constraints or unable to effectively work, you may prefer to seek minimally invasive treatment for your claudication. Call us to assess whether you may a candidate.
COMPREHENSIVE PAD AND CLI CARE
We are board-certified interventional specialists with deep experience in evaluating and treating PAD and CLI by minimally invasive techniques on an outpatient basis in a personal non-hospital environment. We have the latest equipment and use the most sophisticated methods to reestablish blood flow in diseased, narrowed or occluded arteries to the legs and feet, causing CLI. These include angiography, IVUS (intravascular ultrasound), angioplasty, atherectomy, recanalization and stenting. Many of you may have had similar procedures performed in your heart.
CRITICAL LIMB ISCHEMIA (CLI)
The arteries in some peoples’ legs continue to narrow or become occluded, causing worsening of symptoms known as critical limb ischemia (CLI). This may be partially relieved by sitting up and dangling the feet downward to improve blood flow. Pain and disability may become so severe as to prevent walking. If you are experiencing signs or symptoms of CLI, call us to promptly assess whether you may a candidate for revascularisation, or contact another vascular specialist. Finally, the circulation in some legs, particularly those of diabetics, may progress to the point of tissue loss (ulcerations) involving the heel or toes. In some patients, prompt treatment to reestablish blood flow to the foot may help to promote tissue healing partially or fully. Nevertheless, patients with tissue loss almost always require prolonged care by a multi-specialty team.
IRREVERSIBLE LIMB ISCHEMIA
The final irreversible phase of PAD is gangrene (tissue death) which usually requires amputation to prevent generalized infection, possible kidney failure and death.
TAKEAWAY MESSAGE
PAD is a spectrum of disease occurring over a period of time. Most patients require long term surveillance and care. We are your trusted partners in health and well-being, ready to provide the expertise, minimally-invasive treatment and continuity of care you deserve.