Hall - Garcia Cardiology Associates

affiliated with the
TEXAS HEART INSTITUTE
Houston, Texass

Peripheral Vascular Disease
 

Introduction Peripheral vascular disease is a form of atherosclerosis, a hardening of the arteries, and is a progressive disease process. It can result in blockages in arteries of the brain, arms, kidneys, and legs. Atherosclerosis is caused when fatty substances build up inside the artery walls over time and create an occlusion which restricts proper blood flow. In the peripheral or non-heart vessels, this is most likely to occur in the iliac arteries (lower abdomen  leading to the legs), the femoral and popliteal arteries (legs), the renal arteries (kidneys) and the carotid arteries (in the neck leading to the brain) and subclavian arteries (arms). You will find answers here to some questions you may have about peripheral vascular disease and its treatment alternatives. Please realize, however, that everyone's situation may be different and may vary slightly from what is described here. Please feel free to contact us and express your questions at any time.   Disease Symptoms When organs and muscles in the body receive an insufficient supply of oxygen-rich blood, they literally become starved and alert you to this fact by producing pain. If the blockage occurs in the arteries supplying the legs, the resulting symptom is a cramping pain in the hips, thighs or calf muscle and can limit even casual walking. If the pain is relieved with rest, we call this condition "intermittent claudication". If blood circulation becomes so severely restricted that the legs and feet are perpetually starved for nutrition, gangrene -- death of the tissue -- can occur. Without treatment, the entire foot or possibly part of the leg may have to be amputated However if discovered in time an appropriate treatment regime may be possible to avoid this devastating event!. Illiac artery stent Renal Artery Angioplasty Other symptoms of peripheral vascular disease in the lower extremities include: coldness of the leg and foot; paleness of the leg or foot if elevated; blue/red discoloration of the foot or toes; dry, fragile or shiny-looking skin; numbness, tingling or pain in the leg, foot or toes; and sores that do not heal. Symptoms of peripheral vascular disease in the renal arteries include hypertension (high blood pressure) - consistently higher than 160/100 despite adequate medication therapy and/or abnormal kidney function blood tests. Stented Carotid Artery  Symptoms of peripheral vascular disease in the carotid arteries include: sudden, temporary weakness or numbness of the face,  arm and/or leg on one side of the body; temporary loss of speech or trouble speaking or understanding speech; temporary dimness  or loss of vision, particularly in one eye; and unexplained dizziness, unsteadiness or sudden falls. Transient Ischemic Attacks (TIA's) or mini-strokes illicit the same symptoms named above except they are temporary. New advances in the treatment of blockages of the carotid arteries include balloon angioplasty and stent implantation. It must be stated, however, that only surgery of these diseased blood vessels has been approved to date. Nevertheless, Dr. Neil E. Strickman is an FDA approved investigator for patients who may be candidates for Carotid Stenting. Other conditions can also cause these symptoms. Therefore, a thorough examination with a physician is necessary. Diagnosis When any of the above-named symptoms occur, a history and physical examination accompanied by an ultrasound Doppler test are initially performed. The ultrasound Doppler test provides an image of  the inside of the arteries using sound waves to determine if there is plaque buildup, and if so, to what extent. This test is simple,  painless, and can be performed as an outpatient procedure in the Cardiologist's office. If the test shows that the stenosis (or narrowing of the artery) is severe, then a test called an arteriogram or angiogram will give your physician the complete information he or she needs to properly diagnosis your condition.   Treatment Alternatives Many treatments can be used to improve blood flow through the peripheral arteries. The latest interventions for treating peripheral vascular disease can bring swift relief and are more cost effective than surgery. Most procedures are performed on an outpatient basis or require no more than an overnight hospital stay, whereas patients enjoy an early return to most normal activities. Techniques now available to you include: the use of balloon catheters, stents, stent-grafts, atherectomy, and laser assistance. All these alternatives treat the build-up of plaque by either  removing it, compressing it or displacing it. During these procedures the physician will periodically inject a contrast dye and take x-ray pictures to determine whether or not the artery is sufficiently opened. If the blockage is extremely long or has become very hard and calcified with time, it may be resistant to any of these  interventions. In these cases, surgery may be required to bypass the problem area.

 © 1998, 2000, 2002, 2003, 2004, 2005, 2006, 2007, 2008 by Hall-Garcia Cardiology Associates - Last revised October 15, 2008

Please contact our WebMaster with any questions or comments