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Peripheral Arterial Disease (PAD)

What is Peripheral Arterial Disease (PAD)
Peripheral arterial disease (PAD) is a disorder that occurs in the arteries of the circulatory system. That’s the system that moves blood throughout the body. In PAD, the walls of the arteries become narrowed or blocked with plaque. Plaque is a combination of cholesterol, fat and/or scar tissue. PAD affects the limbs, usually the legs. Left untreated, it can cause many serious and life-threatening conditions including amputation, stroke or heart attack. PAD also is known as hardening of the arteries, atherosclerosis and peripheral vascular disease. It’s estimated that one in every two persons, age 60 or older, has peripheral arterial disease.


Symptoms of PAD
More than 50 percent of patients with PAD do NOT experience symptoms. Patients with symptoms may experience one or more of the following:

  • Pain when walking, especially calf pain
  • Leg or foot sores that don't heal
  • Achiness in the leg or legs
  • Skin discoloration
  • Cold legs or feet
     

Risk Factors

  • Obesity
  • Diabetes
  • History of SmokingTreatment Options
  • Aging (especially after age 50)
  • High blood pressure
     

How PAD Is Diagnosed
The initial screening for peripheral arterial disease measures the blood pressure in the limbs. It is called a non-invasive vascular study. If PAD is found, a CT angiogram or a catheter-directed angiogram is needed to determine the exact level of disease. An angiogram is a radiological examination of the arteries.

Treatment Options
There are several non-surgical options available. At Mallinckrodt Institute of Radiology, these procedures are performed by specialized radiologists called interventional radiologists. Interventional radiology (IR) procedures to treat PAD are:

Angioplasty: In this procedure, a thin tube called a catheter is inserted into the affected artery. When in position, a tiny balloon is temporarily inflated at the tip. The balloon presses the plaque into the walls of the artery to improve blood flow. A stent — a tiny tube —helps to keep the arteries open.

There are two types of stents:
Bare metal stents: This tiny, scaffold-like device is made of metal mesh. Although this type of stent prevents the artery from collapsing, it does not prevent scar tissue from accumulating that can cause a re-blockage.
Stent-grafts (covered stents): This type of stent is covered with a synthetic fabric coated with a medication. The medication is slowly released to help prevent the growth of scar tissue in the artery lining.

Atherectomy: This is an alternative to an angioplasty. In this procedure, a tiny cutting device at the tip of the catheter removes the blockage. It cannot be performed on clots below the knee.

Thrombolytic therapy (clot busters): This is the use of drugs, administered with a catheter, to dissolve clots and improve blood flow.
 

Benefits of Interventional Radiology (IR) over Surgery

  • Less risk of infection
  • Local anesthesia versus general anesthesia
  • Less pain and scarring
  • Faster recovery and return to normal activities
     

Why MIR?

  • We specialize in patients who are not candidates for surgery
  • Our interventional radiologists are experts in catheter-driven therapy
  • No group has more catheter-driven experience in the bi-state region
  • We will evaluate your condition and communicate our findings with your referring physician

Insurance
As with most IR procedures, they are generally covered if the patient is symptomatic.

Associated Physicians
Gretchen Foltz, MD
Ramanathan Rami, MD
Raja Ramaswamy,MD

Consultation/Contact Us
To schedule an appointment, call 314-362-2900.

FAQ
https://www.mir.wustl.edu/appointments-referrals/for-patients