Peripheral Arterial Disease

What is peripheral arterial disease?

Peripheral Arterial Disease (PAD) is a common circulatory condition in which narrowed arteries reduce blood flow to the limbs, most commonly the legs. It results from the buildup of fatty deposits (atherosclerosis) in the artery walls, which can cause pain and other complications.

How it Works:

Procedure:

  • Angioplasty:
    • A balloon catheter is guided to the narrowed artery and inflated to widen the artery and improve blood flow.
    • Sometimes, a stent (small mesh tube) is placed to keep the artery open.
  • Atherectomy:
    • A  small device is used to remove plaque from the artery walls, improving blood flow.
  • Thrombolysis or Thrombectomy:
    • Thrombolysis involves using medication to dissolve blood clots within the artery.
    • Thrombectomy uses a special catheter to physically remove clots, restoring blood flow.

Imaging:

  • Doppler Ultrasound:
    • Before the Procedure: Doppler ultrasound is often the first-line imaging to assess blood flow, detect blockages, and evaluate the severity of PAD. It is non-invasive and helps determine whether further intervention is needed.
  • Angiography (Fluoroscopy with Contrast Dye):
    • During the Procedure: Angiography is the primary imaging method during PAD procedures. A catheter is inserted into the artery, and a contrast dye is injected. Real-time X-ray imaging (fluoroscopy) shows the dye’s movement, highlighting blockages and guiding the placement of balloons, stents, or clot-removal devices.
    • After the Procedure: Angiography is also used post-procedure to verify that blood flow has been restored to the treated artery.
  • Computed Tomography Angiography (CTA) or Magnetic Resonance Angiography (MRA):
    • Before or After the Procedure: CTA or MRA may be done before PAD treatment for detailed, cross-sectional images of the blood vessels. These scans help assess the precise location and size of the blockage and guide treatment planning.

Why It’s Done:

  • Restore Blood Flow: Blockages from PAD can lead to severe pain, tissue damage, and even amputation if untreated. These procedures relieve arterial blockages and improve circulation to the affected limbs.
  • Relieve Symptoms: Symptoms such as leg pain, cramping, and difficulty walking can be relieved, improving mobility and quality of life.
  • Prevent Complications: PAD can lead to non-healing wounds, infections, and ulcers in the limbs. Procedures reduce the risk of these complications, especially in diabetic patients or those with severe PAD.

By addressing the restricted blood flow, PAD procedures aim to alleviate symptoms, prevent limb loss, and improve patients’ overall health and quality of life.