Doctor insights on:
Why Does Untreated Peripheral Arterial Disease Lead To Loss Of Leg
Arteries are defined as blood vessels which carry blood away from the heart (to either the body or lungs). Arteries: higher pressure, thicker walls, stretch (pulse) with each heart contraction & deliver blood to the arterioles which control the flow to individual capillaries. Veins are blood vessels which carry blood from capillaries back to the heart (body to right heart; ...Read more
Possibility: If tissue dies or severely infected, amputation can be life-saving. In completely uncontrolled pad, it is very, very common, especially if uncontrolled diabetes and tobacco use. To treat, stop smoking, control diabetes. May be given blood thinners or blood vessel dilators. Artery bypass may be also recommended. See a vascular surgeon for treatment options. ...Read more
Is it possible if I have high blood pressure I could have developed peripheral arterial disease undetected and could this lead to an ankle fx nonunion?
Not always: Pad can technically refer to any arterial disease outside the aorta or coronary vasculature. It is frequently in the legs, but also commonly in the carotid arteries, and sometimes in the arteries of the arms or stomach organs. The last two are rarer. Pad is important because the underlying process that causes arterial blockages is essentially the same no matter which arteries are involved. ...Read more
PAD is a range: Many people have pad but it doesn't always produce symptoms. At its earliest stages pad can cause a cramping or tightness of the legs with walking, and this is called "intermittent claudication." when you rest the cramping/tightness usually goes away. At more advanced stages of pad symptoms can be present all the time, and this is called "ischemic rest pain." this is present regardless of activity. ...Read more
Risk vs Benefit: There is risk with all surgeries even those done with wires manipulated through the arteries (angiography/angioplasty). In experienced hands, these risks are minimal. However, pad if untreated can lead to severe pain, open ischemic ulcers, gangrene and loss of your limb. Given the choice, if you are having symptoms, then treatment is safer than waiting. ...Read more
PVD: Patients who need arterial bypass for PVD usually have coronary artery disease, hypertension and often diabetes. This combination or individually raises the risk of any surgery. When we do PVD surgery it is usually because a limb is threatened, saving a limb is a pretty prominent benefit in most people's risk/benefit equation. ...Read more
Yes,: Certainly possible.Get a more detailed answer ›
I have swelling in my right foot and ankle causing pain. I also have peripheral arterial disease. What specialist should I see?
Orthopedic: Surgeon is a good place to start. ...Read more
Symptoms are rare: As dr. Wyffels said, autopsies on soldiers in viet nam showed early evidence of pad in young men as early as their 20's but having symptoms from pad when you are 20 would be exceedingly rare. ...Read more
Leg pressures: Non-invasive studies that measure your blood pressure in different locations of the leg are a great way to confirm peripheral artery disease. The blood pressures in the thigh, calf, ankle, and toes are measured along with special waveform tracing gives the best functional information about your disease. No other test (including angio or ultrasound) gives more functional information than this test. ...Read more
Yes: They are completely different. Venous disease is somewhat genetic, but if people lived long enough almost everyone would probably get venous disease at some point in their life. In fact 15% of the adult population has venous disease. Arterial disease, in contrast, is not as common in the general population. It occurs in smokers, diabetics, and in people with high blood pressure and cholesterol. ...Read more
Worse with age: Peripheral arterial disease is when the arteries (the vessels that carry the healthy, oxygenated blood to the tissues), become compromised (narrowed, blocked) and the tissues get less blood flow. This worsens with age due to the cumulative effects of the many factors that affect us (cholesterol, smoking, obesity, lack of activity). As we get older, these get worse and affect us more and more. ...Read more
A principal symptom: Claudication, or the tensing up of the calf muscles during walking, is the main symptom of peripheral arterial disease. It is caused by blockages in the arteries that give blood supply to the calf muscles. Claudication may be called "intermittent" because it goes away when one stops walking and may recur on resuming walking -unlike spinal stenosis which causes rest pain down the legs. ...Read more
Lots of Choices: Usually, initial treatments are conservative, exercise, cessation of smoking, medicines to make the blood flow better and to reduce cholesterol. More aggressive is to open blockages with balloons or stents. Finally, surgery to bypass around the blockages or directly clean out the blocked artery is sometimes needed. ...Read more
Treat symptoms: The mere presence of narrowing or compromise of blood flow in arteries is not a reason for treatment unless there are symptoms. Ulcers, pain, gangrene are symptoms that in the presence of pad need to be treated. Just because there is narrowing of the arteries without symptoms, does not warrant any treatment. Prevention by not smoking, blood sugar and cholesterol control and excercise will help. ...Read more
Possibly: Although disease of the arteries of the legs is seldom life threatening untonitself, it is often a marker of more diffuse atherosclerotic disease including carotid disease and coronary heart disease. Therefore, strokes and heart attacks can manifest in many patients with pad. ...Read more
No cure but...: Treatment always starts with risk factor management. Smoking cessation, lipid control, BP control, exercise, wt loss. Balloon angioplasty, stenting, athrectomy, direct removal of plaque (endarterectomy) and bypass surgery are all possible treatments depending on symptoms. Vascular surgeons provide all of these and so are uniquely qualified to manage patients with pad in an unbiased manner. ...Read more
Youthful PAD: The simplest test is to use a doppler and check blood pressures in the arms and ankles and compare. Pad will make them different. Signs and symptoms can include cold feet, bluish toes, pain in the calves with walking, ulcers of the feet and toes and gangrenous changes of the feet. Many diseases can mimic these symptoms so a vascular or wound specialist is needed. ...Read more
Yes: While uncommon people as young as 20 may have peripheral arterial disease, though this is usually the result of a number of vasculitidies such as takayasu's arteritis or berger's disease. More commonly pad is found in people over the age of 50, and quite prevalent in those over age 70. Smoking is the biggest risk factor in developing pad, conferring a 16x higher risk than a non-smoker. Don't smoke. ...Read more
Bad stuff: The key ingredient in cigarettes is nicotine. Our arteries have a muscular lining that can relax to increase flow and "squeeze" to reduce flow. Nicotine causes the lining to squeeze down and also causes damage to the lining which causes inflammation. Hard calcium is deposited which further narrows the vessels permanently reducing blood flow. This occurs in every artery when you smoke! ...Read more
Lots: Most patients with peripheral arterial disease (pad) do relatively well. Lowering your cholesterol, stopping smoking, a walking program, and stopping smoking (mentioned twice because its that important) may stabilize symptoms if not improve them. Some (not most) patients require more invasive treatment either by angioplasty or surgery. Treatment options are continuing to improve. ...Read more
Youthful PAD: Pad occurs when there is a narrowing of the arteries. While there are many causes, the most common is a build up of calcified plaque which takes years to occur and is most commonly associated with cigarette smoking, high cholesterol and diabetes among other things. It is extremely rare for these to occur in the young. ...Read more
PEripheral arterial disease refers generally to the arterial supply to the extremities and can involve vessels of any size. Diseases like diabetes tend to affect the small arterial vessels while atherosclerosis from high cholesterol, hypertension, or smoking to name a few can affect vessels if any size. The concern is inadequate blood and oxygen to ...Read more
- Talk to a doctor online
- Peripheral arterial disease
- How does malnutrition lead to coronary heart disease?
- Untreated cellulitis of the legs
- Can an untreated bladder infection lead ro sepsis?
- Why does rupture of the chordae tendineae lead to valve dysfuction?
- Arterial sclerotic cardiovascular disease
- Why does pancreatitis cause peripheral neuropathy?