Category: Peripheral Arterial Vascular

Common Peripheral Artery Disease Treatments

Peripheral Artery Disease is a severe form of vascular disease that affects the arteries outside of the heart, primarily the lower extremities. Peripheral Artery Disease or PAD is a gradual build-up of plaque on the walls of the arteries. This gradual build-up of plaque hardens the arteries, making them less flexible and narrows the opening for blood to flow from the heart to all the appendages freely. Many PAD patients have burning, aching pain after walking or pain in the calf, thigh, or buttocks. Treatment for PAD is varied and depends on the seriousness of the disease.

Your Vascular Surgeon will discuss an individualized systematic review of all available treatment modalities, generally from the least invasive to most invasive, and suggest the most appropriate treatment based on how the disease has progressed and what is in the best interest of each patient. Vascular Surgeons are the only specialist able to provide all treatment options ranging from medications to open surgical bypass but generally try to provide the least invasive form of treatment first.

Most common treatments for PAD 

Lifestyle Changes:

  1. Walking is one of the most effective measures a patient can take to reduce the symptoms of PAD. Walking has been found to reduce the symptoms and stop further disease progression. Although PAD cannot be totally healed, its progression can be slowed to the point that it does not affect the patient’s activities of daily living. Walking reduces plaque build-up and helps to lower cholesterol and blood pressure, and aids in maintaining a healthy weight.
  2. Smoking cessation – Smoking is one of the main risk factors for PAD. Smoking damages blood vessels and makes it difficult for the blood to flow compressed arteries. Smoking also increases the risk for blood clots by decreasing the movement of cholesterol through the arteries and hardening the arterial walls.
  3. Diet – A healthy diet plays a serious role in overall vascular health. Avoiding foods high in fat and adding fresh fruits and vegetables dramatically reduces the effects of PAD.

Medications Symptom relief medication- Your doctor may prescribe medication to increase blood flow, thin the blood, and assist in widening the vessel body.

  1. Blood clot prevention – Medications such as Plavix are used to reduce the chance of blood clots and improve overall blood flow.
  2. Medication to control blood sugar – For patients with diabetes (Another top risk factor for PAD), reducing sugar levels in the blood is paramount. High levels of sugar in the blood damage the arteries’ lining, making it much more susceptible to atherosclerosis.
  3. Medication for high blood pressure – High blood pressure over time can weaken the arterial walls. Reducing the pressure where/when possible is essential in keeping the arterial walls healthy.
  4. Medication to lower cholesterol – LDL cholesterol is the fatty substance that builds up in your bloodstream and forms a plaque on the arterial walls that reduce the artery’s diameter, making it much more difficult for blood to flow through.

Minimally Invasive (In-office procedure)

When lifestyle changes and medications do not sufficiently reduce PAD symptoms, your Vascular Surgeon may suggest a minimally invasive vascular procedure to widen the artery at the location where the plaque has reduced the flow of blood. These procedures are done in the “In-Office” angiography suite at our Mesa and Phoenix locations.

  1. The first option of in-office PAD treatment is Angioplasty. In an Angioplasty your Vascular Surgeon will insert a small catheter into your artery, using the artery as a raceway, and place a wire within the catheter that has a balloon on the tip down to the disease area. Once in the disease or narrowed area, the balloon is expanded, pressing the plaque against the wall and opening the artery for a more effortless blood flow.
  2. Another treatment offered in the angiography suite is the use of an atherectomy device. An atherectomy device is guided through a catheter inserted into the artery similar to an angioplasty; then, the device uses high-energy laser light to vaporize the plaque blockage resulting in increased blood flow to the peripheral vessels and tissues.
  3. Stents are another minimally invasive in-office treatment offering vascular surgeons use to improve symptomatic PAD patients. Stents are also placed via a catheter in the artery and are guided to the diseased area after ballooning to create a structural scaffold to hold the diameter of the artery wall open for patent blood flow.

These minimally invasive treatments are used in concert to provide patients with minimally invasive yet highly effective treatments for PAD by a Vascular Surgeon. This form of treatment is almost always performed before taking the patient into the hospital, hoping that a less invasive procedure will provide relief and vascular improvement in a more comfortable setting. Patients who have angio procedures in our in-office angiography suite leave the same day as their treatment, generally within a few hours of the operation.

Hospital-based surgical procedures are the last level of treatment when the other treatments options have not been sufficient, or the disease has progressed past their efficacy. Vascular Surgeons are the only “vascular specialist” that can provide all the other procedures and hospital-based open and endovascular surgical procedures. Our surgeons are Board Certified and Fellowship Trained, holding hospital privileges at all local hospitals with vascular capabilities. These in-hospital vascular treatment options are as follows:

  1. Bypass surgery – Your vascular surgeon may choose to perform bypass surgery to treat your PAD. Bypass is accomplished by redirecting the flow of blood around the diseased area. In bypass surgery, a Vascular Surgeon will either use a synthetic graft or the patient’s vein to make a new route around the blocked or narrowed area “bypassing” to the site of best blood flow.
  2. Endarterectomy – A Vascular Surgeon performs this treatment in the hospital by making an incision at the site of the arterial blockage. The blood from the artery will be rerouted around the blocked area during the surgery. The artery is opened at the blockage site and then removed. After removal, the artery is stitched up, and the reroute removed. The artery now has open blood flow throughout, improving the patients’ symptoms.

Western Vascular Institute’s team of Board-Certified Fellowship-Trained Vascular Surgeons are privileged at all local hospitals with vascular capabilities. Our surgeons can provide individualized and unparalleled care for patients suffering from Peripheral Artery Disease (PAD) throughout Arizona.

If you or someone you know has PAD, or you would like to find out if you have PAD call the number below to schedule a new patient appointment or follow this hyperlink to a Peripheral Artery Disease quiz.

(480) 668-5000

https://www.westernvascular.com/pad-test/

 

Intrasight Mobile IVUS

Western Vascular Institute is excited and honored to announce that we have been chosen as 1 of only 6 locations globally to apply a new intravascular ultrasound technology, the IntraSight Mobile IVUS by Philips.

This amazing new technology provides smart, accurate images inside vessels allowing vascular surgeons the ability to more accurately visualize, plan, diagnosis, and treat peripheral vascular disease during interventional procedures.

We are grateful for this opportunity to be a part of the rollout of this new device. It is not only an incredible honor, but it also shows the caliber of Doctors and staff here at Western Vascular Institute.

https://www.usa.philips.com/healthcare/resources/landing/intrasight

https://www.westernvascular.com/vascular-surgery/peripheral-vascular-disease/

 

 

Ankle Brachial Index

An ankle-brachial index is a simple and non-invasive test performed to diagnose peripheral vascular disease. The index compares the blood pressure of the legs and arms and creates a ratio that shows the availability of blood to flow freely from one extremity to the other. The ABI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressure in the arm.

During this test, patients lie on their back and a technician places blood pressure cuffs on the ankles and arms. The machine then inflates the cuffs alternating to get the ratio. This test may include exercise by walking on a treadmill for several minutes in order to simulate when a patient would feel pain due to peripheral artery disease and then takes the reading afterward to understand the severity of the said disease.

https://www.westernvascular.com/testing-center/

https://vascular.org/patient-resources/vascular-tests

 

Peripheral Artery Disease

 

Artery

  •  An artery is a blood vessel that carries blood from the heart to other parts of the body.
  • Arteries are thicker than veins and have more robust, more elastic walls.
  • Arteries sometimes develop plaque within their walls in a process known as atherosclerosis.
  • These plaques can become fragile and rupture, leading to complications associated with diabetes, such as heart attacks and strokes.

Peripheral arteries

  • Peripheral arteries send oxygen-rich blood to all parts of the body.
  • In PAD, plaque builds up in the artery walls.
  • Just like coronary artery disease, plaque narrows the arteries and leaves less room for blood to flow through. 
  • If your legs do not get enough oxygen and nutrients, they will feel sore or tired when you walk or climb stairs.
  • Having PAD raises your chances of a heart attack or stroke.
  • With PAD, not enough oxygen-rich blood and energy can pass through the arteries due to narrowing. 


The following symptoms may indicate the disease:

weakness in legs; numbness or cramping in legs with walking; legs may feel cold; color change, dark pink, purplish, dusky.

The symptoms may be present or absent but are due to a lack of blood flow to the muscle group, resulting in pain in the affected muscle groups. However, if the individual has diabetes or neuropathy, they may not feel the pain.

The presence of an extremity ulcer is one of the more obvious clinical signs of poor circulation. Other common symptoms: pain with walking a short distance; pain at rest when legs are elevated, but lessens when legs are dangled over the side of the bed or sofa.

Additional warning signs:

  • If you have poor circulation, it will typically begin in your legs first
  • Pain in the calf muscles when you walk (claudication) is the most common symptom
  • Poor wound healing or decline in the pulses in your feet
  • These symptoms may indicate severe blockages in the vascular system
     

https://vascular.org/patient-resources/vascular-conditions/peripheral-arterial-disease

Peripheral Artery Disease

 

What is Claudication?

Claudication, also referred to as intermittent claudication, is pain caused by reduced blood flow to the lower extremities.  Claudication is a symptom of the disease called Peripheral artery or peripheral vascular disease (PAD or PVD) rather than a disease itself.

Claudication can cause:

  • Pain in calves, thighs, feet, or other parts of the lower extremities
  • Pain at rest, that gets worse with movement
  • Discolored skin
  • Weakness in leg
  • Aching or burning sensation in extremities

https://www.westernvascular.com/vascular-surgery/peripheral-vascular-disease/

https://vascular.org/patient-resources/vascular-conditions/peripheral-arterial-disease

The Joint Commission Gold Seal Of Approval / Certification

The Joint Commission?

What is it?

The Joint Commission is an independent non-profit organization that accredits and certifies healthcare organizations in the United States. A Joint Commission accreditation and Gold Seal of approval is a symbol of Quality and Excellence that reflects an organization’s commitment to meeting and exceeding performance and safety standards.

Why should you care?

Hospitals are required to be joint commission accredited in order to provide the safest and appropriate care for their patients. But Accreditation is not required for outpatient centers such as Western Vascular Institute. Western Vascular requests these audits and subjects themselves to intense scrutiny to show our patients our continued commitment to quality care & outcomes in vein and artery treatments.

Are All Vein and Vascular centers accredited?

No, in fact, Western Vascular Institute is the only Vein and Vascular group in Arizona providing in-office care, dedicated to peripheral vascular disease accredited by The Joint Commission.

We believe that quality is the result of excellent work without compromise.

 

What is a Vascular Ultrasound?

Vascular Ultrasound or Duplex study

 

A Vascular Ultrasound or Duplex study is a non-invasive test performed to evaluate a patient’s blood flow through the arteries and veins. The test provides Vascular Surgeons with the information they need to provide a diagnosis and set a course of treatment for each patient. All the ultrasound technicians at Western Vascular Institute are trained specifically in Vascular sonography, and the IAC Intersocietal Accreditation Commission accredits our facilities for vascular sonography.

Patients can rely on accreditation to indicate that the facility that performs their examination has proven a commitment to providing quality testing for the diagnosis of vascular disease. Patients can rest assured that accredited facilities have been carefully critiqued on all aspects of their operations considered relevant by medical experts in the field of vascular technology.

Health care organizations are held to very high levels of accountability by peers and the general public. In numerous states, reimbursement directives that require accreditation of the facility have been instituted by Medicare carriers and private, third-party insurers. Similar draft payment policies are pending throughout the United States. Facilities attaining accreditation before it is required for reimbursement demonstrate a willingness to surpass current expectations.

The general public and the vascular testing community members will recognize an unmatched commitment to providing quality health care by facilities that achieve IAC Vascular Testing accreditation.

 

https://vascular.org/patient-resources/vascular-tests

What is Atherosclerosis?

Atherosclerosisis a disease process that leads to the hardening or clogging of arteries. The build-up over time of substances such as fat, cholesterol, & calcium, collectively called plaque, narrows the artery and restricts the amount of blood able to pass through the arteries, and provides oxygen-rich blood to the body. This stenosis or narrowing of the artery can lead to serious problems such as stroke, amputation, heart attack, and death.

 

What is Limb Salvage?

Introduced by Western Vascular Institute over 20 years ago, limb salvage of the leg, foot, & ankle is a term used to describe the type of procedure that our wound & Vascular board-certified surgeons are able to provide to save a patients leg from amputation due to peripheral artery disease, diabetes & many other conditions.

In this procedure, our surgeons, because of their unparalleled training & skill level, are able to open arteries through endovascular catheters all the way down to the toes. This allows for blood flow to reach all the way to the tips of the toes, which helps patients improve their mobility & ability to heal wounds as well as saving or “salvaging” their limbs from amputation.

 

 

 

 

 

 

 

 

 

 

 

 

 

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