Patient FAQs  Peripheral Arterial Disease (PAD)
Q: What is peripheral arterial disease (PAD)?
A: Peripheral arterial disease (PAD) happens when the arteries in your legs become blocked.
A fatty substance called plaque ('plak') grows inside the walls of the arteries that carry blood from your heart to your legs and feet.
Your legs do not get enough blood and oxygen when this happens.
This can cause pain, infection and wounds in your feet and legs.
Q: What causes PAD?
A: You are more likely to get PAD if you have diabetes, high cholesterol, high blood pressure, or if you smoke or are overweight.
You are also more likely to get it as you get older or if your family members have it.
If you have blocked arteries in other parts of your body, such as your heart or brain, you are also more likely to get PAD.
Q: How do I know if I have it?
A: Sometimes people with PAD have no symptoms.
If your blockage is severe, you may have some or all of these symptoms:
- Aches, cramps or pain in your legs or buttocks when you walk or exercise.
The pain usually goes away when you rest.
Or you may have pain all the time that gets worse with walking or exercise.
- Darkening or discoloration of the skin in the legs and feet
- Hair loss on the legs
- Wounds that do not heal or heal slowly, wound infection or gangrene (death of a body part-usually a toe or foot)
There are different ways to test for PAD.
The main tests done are Ankle Brachial Index (ABIs), Doppler Ultrasound and Angiography.
You can read about these tests in the Vascular Tests and Studies sheet.
Q: What happens now that I've been told I have PAD?
A: Your doctor may want you to see a vascular surgeon.
A vascular surgeon is a specialist in treating diseases of the arteries and veins.
During your appointment, the surgeon will discuss possible treatments with you.
The surgeon may recommend medication, minimally invasive procedures or surgery to look at and open up blocked arteries.
Q: If I need a procedure or surgery, what happens?
A: Your vascular surgeon will give you a date to come to the operating room.
In the operating room, the surgeon may do an Angiogram.
This is an X-ray of the blood vessels in the legs.
A contrast ('dye') is injected through a small catheter (thin flexible tube) into the leg arteries.
If this exam shows that your arteries are blocked or stenosed (narrowed), your surgeon may do one of these treatments:
- Angioplasty: A tiny balloon is placed into the stenosed artery and then filled with air.
This balloon widens the narrowed area and lets blood flow through the artery.
The air is then taken out balloon and the balloon is removed.
- Stent: A stent is a small plastic or metal mesh tube that is placed in an artery.
It may be put in to help keep the artery open after angioplasty.
For these procedures, the nurse will connect you to monitors, to watch your vital signs (blood pressure, heart beat, breathing).
Medicine is used to numb the groin where the catheter is placed through a tiny cut.
You will also be given pain medicine and sedatives (medicine to make you sleepy) through an intravenous (IV) line in an arm vein.
Most people go home the next day.
- Atherectomy: a tiny cutting device is inserted in the artery.
It is used to shave away the material that is causing the blockage in the artery.
- Surgery: Sometimes the blockage or stenosis is in a place that cannot be opened by angioplasty.
In this case, you may need 'bypass surgery'.
The surgeon uses one of your veins or a graft (man-made tube) to make a detour around the blocked area.
This detour makes a new path for blood to flow.
You will be given general anesthesia (you will be asleep) for this surgery.
You will stay in the hospital for 3 or 4 days after it.
Q: Is there anything I can do to prevent or treat PAD?
A: You are less likely to get PAD if you control your diabetes, high blood pressure and cholesterol, lose weight and stop smoking.
Your overall health will also get better.
Plaque build-up can be stopped or undone, and medicines or surgery may improve blood flow.
- Stop smoking:
Smokers tend to get PAD about 10 years earlier than non-smokers.
- Start exercising:
Exercise can help lessen pain that you feel when walking. Make sure to discuss any exercise program with your doctor before you start.
- Eat healthy:
You can lower your cholesterol by eating healthy, but you may also need medications to lower your cholesterol to a good level.
- Take your medicines:
If your doctor has prescribed medication for you, it is important that you take it.
Medicine can help to keep your cholesterol, blood pressure and diabetes under control, improve the blood flow in your blood vessels, and/or keep your blood from clotting.
Q: What do I do if I have questions?
A: If you are confused or have a question about peripheral arterial disease, please call us at 212.932.4325, at any time.
You can also find information at our website: www.ColumbiaWoundHealing.org.
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