Surgery For Peripheral Vascular Diseases
Surgery For Peripheral Vascular Diseases
Peripheral Artery Disease is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.When plaque builds up in the body’s arteries, the condition is called atherosclerosis. Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. PAD usually affects the arteries in the legs, but it also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. As with clogged arteries in the heart, PAD raises the risk of heart attack, stroke, and even death.
The most common cause of peripheral artery disease (PAD) is atherosclerosis. Atherosclerosis is a disease in which plaque builds up in your arteries. The exact cause of atherosclerosis isn’t known.The disease may start if certain factors damage the inner layers of the arteries. These factors include:
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Smoking
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High amounts of certain fats and cholesterol in the blood
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High blood pressure
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High amounts of sugar in the blood due to insulin resistance or diabetes
Intermittent Claudication
People who have PAD may have symptoms when walking or climbing stairs, which may include pain, numbness, aching, or heaviness in the leg muscles. Symptoms also may include cramping in the affected leg(s) and in the buttocks, thighs, calves, and feet, which may ease after resting. These symptoms are called intermittent claudication.
During physical activity, your muscles need increased blood flow. If your blood vessels are narrowed or blocked, your muscles won’t get enough blood, which will lead to symptoms. When resting, the muscles need less blood flow, so the symptoms will go away.
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Other Signs and Symptoms
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Other signs and symptoms of PAD include:
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Weak or absent pulses in the legs or feet.
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Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all.
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A pale or bluish color to the skin.
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A lower temperature in one leg compared to the other leg.
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Poor nail growth on the toes and decreased hair growth on the legs.
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Erectile dysfunction, especially among men who have diabetes.
Intermittent Claudication
People who have PAD may have symptoms when walking or climbing stairs, which may include pain, numbness, aching, or heaviness in the leg muscles. Symptoms also may include cramping in the affected leg(s) and in the buttocks, thighs, calves, and feet, which may ease after resting. These symptoms are called intermittent claudication.During physical activity, your muscles need increased blood flow. If your blood vessels are narrowed or blocked, your muscles won’t get enough blood, which will lead to symptoms. When resting, the muscles need less blood flow, so the symptoms will go away.
Treatment
Treatments for peripheral artery disease (PAD) include lifestyle changes, medicines, and surgery or procedures.The overall goals of treating PAD include reducing risk of heart attack and stroke; reducing symptoms of claudication; improving mobility and overall quality of life; and preventing complications.Treatment is based on your signs and symptoms, risk factors, and the results of physical exams and tests.Treatment may slow or stop the progression of the disease and reduce the risk of complications. Without treatment, PAD may progress, resulting in serious tissue damage in the form of sores or gangrene (tissue death) due to inadequate blood flow. In extreme cases of PAD, also referred to as critical limb ischemia (CLI), amputation (removal) of part of the leg or foot may be necessary.
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Lifestyle Changes
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Treatment often includes making long-lasting lifestyle changes, such as:
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Physical activity
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Quitting smoking
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Heart-healthy eating
Physical Activity
Routine physical activity can improve PAD symptoms and lower many risk factors for atherosclerosis, including LDL (“bad”) cholesterol, high blood pressure, and excess weight. Exercise can improve the distances you can comfortably walk.Talk with your doctor about taking part in a supervised exercise program. If a supervised program is not an option, ask your doctor to help you develop an exercise plan. Most exercise programs begin slowly, which includes simple walking alternating with rest. Over time, most people build up the amount of time they can walk before developing pain. The more active you are, the more you will benefit.
Quitting Smoking
If you smoke, quit. Smoking raises your risk for PAD. Smoking also raises your risk for other diseases, such as coronary heart disease and heart attack, and worsens other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.Read more about quitting smoking at Smoking and Your Heart.
Heart-Healthy Eating
Your doctor may recommend heart-healthy eating to treat atherosclerosis, the most common cause of PAD. Following heart-healthy eating can help control blood pressure and cholesterol levels, which can lead to atherosclerosis.
Medicines
Your doctor may prescribe medicines to:
Prevent blood clots from forming due to low blood flow with anticlotting medicines, such as aspirin.Treat unhealthy cholesterol levels with statins. Statins control or lower blood cholesterol. By lowering your blood cholesterol level, you can decrease your chance of developing complications from PAD.Treat high blood pressure with one of many high blood pressure medicines.Help ease leg pain that occurs when you walk or climb stairs.Reduce the symptoms of intermittent claudication, measured by increased walking distance with certain platelet-aggregation inhibitors.
Surgery or Procedures
Bypass Grafting
Your doctor may recommend bypass grafting surgery if blood flow in your limb is blocked, or nearly blocked. For this surgery, your doctor uses a blood vessel from another part of your body, or a synthetic tube, to make a graft.This graft bypasses (that is, goes around) the blocked part of the artery. The bypass allows blood to flow around the blockage. This surgery doesn’t cure PAD, but it may increase blood flow to the affected limb.
Angioplasty and Stent Placement
Your doctor may recommend angioplasty to restore blood flow through a narrowed or blocked artery.During this procedure, a catheter (thin tube) with a balloon at the tip is inserted into a blocked artery. The balloon is then inflated, which pushes plaque outward against the artery wall. This widens the artery and restores blood flow.A stent (a small mesh tube) may be placed in the artery during angioplasty. A stent helps keep the artery open after angioplasty is done. Some stents are coated with medicine to help prevent blockages in the artery.
Atherectomy
Atherectomy is a procedure that removes plaque buildup from an artery. During the procedure, a catheter is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off plaque.
The bits of plaque are removed from the body through the catheter or washed away in the bloodstream (if they’re small enough).
Prevention
Taking action to control your risk factors can help prevent or delay peripheral artery disease (PAD) and its complications. Know your family history of health problems related to PAD – if you or someone in your family has the disease, be sure to tell your doctor. Controlling risk factors includes the following:
Be physically active.
Get screened for PAD. A simple office test, called an ankle-brachial index or ABI, can help determine whether you have PAD.
Follow heart-healthy eating.
If you smoke, quit. Talk with your doctor about programs and products that can help you quit smoking.
If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan.
The lifestyle changes described above can reduce your risk of developing PAD. These changes can also help prevent and control conditions that can be associated with PAD, such as coronary heart disease, diabetes, high blood pressure, high blood cholesterol
If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan.
The lifestyle changes described above can reduce your risk of developing PAD. These changes can also help prevent and control conditions that can be associated with PAD, such as coronary heart disease, diabetes, high blood pressure, high blood cholesterol
