Peripheral Artery Disease affects millions of Americans. It occurs when the arteries are narrowed or blocked, making it harder for heart to pump blood to the legs and feet.
Patients notice leg pain, numbness and weakness, and can even face medical emergencies like heart attack or stroke.
The team at The Vascular Institute at Regional One Health can help via lifestyle changes, medication, minimally invasive surgery, and monitoring.
Don’t ignore symptoms like pain, foot wounds, and numbness and weakness in the legs – they could be signs of a vascular disorder called Peripheral Artery Disease, or PAD.
Around 6.5 million Americans over age 40 have PAD, and both men and women are impacted. Fortunately, with proper care and monitoring, patients can lead a normal, active life.
Erica Mitchell, MD, MEd SE, FACS, DFSVS, is Professor of Surgery and Medical Director of The Vascular Institute at Regional One Health. She and fellow University of Tennessee Health Science Center vascular surgeons Maunil Bhatt, MD and Elianne Rojas, DO help PAD patients via lifestyle changes, medication, minimally invasive surgery, and revascularization operations.
“Peripheral Artery Disease occurs when arteries become narrowed or blocked, which is also known as arteriosclerosis,” Dr. Mitchell said. “Because of this, the arteries aren’t able to carry as much blood from the heart to the legs and feet.”
Risk factors include being age 40 or older, smoking, high blood pressure, diabetes, obesity, high cholesterol, and a family history of stroke or heart attack. Dr. Mitchell encourages patients to talk to their health care provider about their personal risk.
It’s also important to recognize the symptoms of PAD. PAD symptoms are most common in the legs and feet, but the condition can occur in arteries throughout the body.
“Many PAD patients have symptoms like leg pain, numbness, or a feeling of weakness, like their legs are going to give out,” Dr. Mitchell said. “Sometimes the legs may appear to lose muscle or hair or have smooth, shiny skin that is cool to the touch.”
As PAD progresses, patients may develop non-healing ulcers in the feet, constant foot pain, and numbness in the foot and toes. The condition can become limb or life threatening: “If patients don’t get treatment, they can have serious emergencies including heart attack, stroke or threatened limb,” Dr. Mitchell said. “Our goal is to help them prevent those major issues.”
When a patient comes to The Vascular Institute with suspected PAD, Dr. Mitchell and her team start by getting a full medical history and performing a thorough physical exam.
The first tests a patient will have are non-invasive: a pulse exam and a Doppler assessment where doctors listen to the flow in the arteries in several locations, and an ultrasound to check blood flow and look for blocked arteries. Some patients also need a CT scan or angiogram for a more detailed view of their arteries.
If a patient is diagnosed with PAD, “Treatment is patient centered and starts with education and lifestyle modifications, unless they need an immediate procedure to increase the blood flow to the affected limb,” Dr. Mitchell said.
Stopping smoking is crucial. Tobacco use is the single biggest risk factor patients can control, and it both increases the chance of being diagnosed with PAD and the chance of the condition becoming severe. A healthy diet, exercise, and managing high blood pressure, cholesterol and diabetes with prescription medication as needed are also important.
“Often, taking these steps allows us to avoid invasive procedures,” Dr. Mitchell said. “If medication and lifestyle changes do not help, we offer both complex endovascular and open procedures to meet specific patient needs.”
Some patients require minimally invasive surgery to place a stent in their blocked artery or clean out the arteries, or a surgical bypass to provide blood supply around a blockage.
“Endovascular surgery is called ‘keyhole surgery,’” Dr. Mitchell said. “There is just a small incision into the artery, and we treat the patient from inside the artery. We always say the main difference between non-vascular and vascular surgeons is that they take things out of the body to treat illness, while we put things into the body to treat illness.”
After an endovascular procedure for PAD, most patients go home the same day and resume normal activities within a few days. Open operations require a longer hospital stay and recovery time.
From there, regular monitoring is key. “We follow our patients for life through regular checkups,” Dr. Mitchell said. “Patients see us every three months the first year, every six months the second year, and annually after that. Surveillance allows us to detect a minor problem in the treated blood vessels before it becomes a serious problem.”
It is a small price to pay for a lifetime of better health, and Dr. Mitchell encourages patients to be vigilant about seeking treatment for PAD and other vascular conditions.
“We help patients get back to work and their normal sports and activities, and we prevent them from needing a major operation,” she said. “The whole goal is to improve their quality of life.”
As home to the only academic vascular and endovascular surgeons in Memphis, The Vascular Institute offers evidence-based, state-of-the-art vascular care. With over 20 years of experience, Dr. Mitchell, Dr. Bhatt and Dr. Rojas help patients achieve optimal outcomes.