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If you've been diagnosed with Peripheral Artery Disease (PAD), you're likely to have some questions.


What is PAD?

PAD is a circulatory problem in which narrowed or hardened arteries, caused by fatty deposits or calcium, reduce or block blood flow to your limbs—usually your legs. As a result, your extremities don't receive enough blood flow to keep up with demand.

How do people get PAD?

As we age, our arteries naturally get stiffer and thicker. Other factors like smoking and diabetes cause damage to the artery lining as well. When this happens, fat and other materials start to build up, creating plaque on the artery walls. As plaque accumulates, it reduces the amount of space in the artery, thereby hindering (and sometimes completely blocking) blood flow.

A number of factors contribute to PAD:

  • Smoking
  • Diabetes
  • High blood pressure
  • High cholesterol
  • History of heart or vascular disease
  • Being age 60 or older
  • Genetics

What are common PAD symptoms?

While PAD often causes no symptoms at all, the most common and earliest complaint is painful cramping in the hips, thighs, or calves when walking, climbing stairs, or exercising.

As PAD progresses, symptoms can become more severe:

  • Leg pain at rest
  • Wounds on the foot that are slow to heal
  • Noticeably cold leg or foot

How does my doctor know if I have PAD?

He or she may have you answer a few questions about your symptoms. If he thinks you may have PAD, he may do a test called an ABI, to determine if you are getting enough blood down your legs, all the way to your feet.

How is PAD treated?

In most cases, a few lifestyle modifications are enough to slow the progression of PAD and reduce or even reverse the symptoms:

  • Quit smoking
  • Control your diabetes
  • Exercise daily
  • Eat healthy diet
  • Watch your cholesterol
  • Keep blood pressure under control

Your doctor may want to treat your PAD with medication, as well. For more advanced PAD, however, your doctor may recommend a surgical or interventional treatment:

  • Bypass Surgery
  • Angioplasty and Stenting
  • Laser Atherectomy

Why do I need to get treatment for PAD?

Left untreated, PAD can lead to more severe—even life threatening—health problems:

  • Heart attack, stroke, or kidney failure

    Blocked arteries in the legs indicate that you're at greater risk for blocked arteries elsewhere—such as the heart, brain, or kidney.

  • Amputation

    Advanced PAD can lead to Critical Limb Ischemia (CLI)—pain, lingering wounds, infection, and dead tissue that must be removed.

While PAD can be life-threatening, it can be managed with proper treatment.

Treatment options for PAD

Depending on the severity of your PAD and your overall health, lifestyle changes and medicine a I one may not be enough to treat your PAD.

Your doctor may recommend one of these treatments:

  • Angioplasty and Stenting
  • Laser Atherectorny

Angioplasty and Stenting

Angioplasty and stenting involve the insertion of a thin catheter (tube) into the affected blood vessel through a small puncture in the skin. With X-ray guidance, the catheter is threaded through the affected artery to the blockage. In angioplasty, a tiny balloon attached to the end of the catheter is inserted and inflated to open the artery. In stenting, a small metal scaffold or wire mesh tube (the stent) is inserted to keep the blood vessel open.

What is Laser Atherectomy?

Laser Atherectomy is a minimally invasive treatment for treating PAD. It works by removing plaque that builds up in your vessels over time, causing a blockage. Once the blockage is removed, your blood will flow better in your legs.

Laser Atherectomy is minimally invasive and requires a short recovery time.

How, exactly, does Laser Atherectomy work?

Laser Atherectomy is typically performed through a very small incision in the upper leg. Guided by X-ray, the surgeon slowly advances the laser catheter through the leg artery to the site of the blockage.

Once in place, the laser produces pulsed bursts of ultraviolet (UV) light energy that can vaporize plaque. The UV light energy is focused on the blockages that need to be treated, removing a tissue layer with each pulse of energy.

The laser catheter moves slowly through the artery, vaporizing the blockage and restoring blood flow. Once the blockage is cleared, the catheter is removed.

It is not unusual that the laser atherectomy process may be followed by balloon angioplasty and/or stenting.

X-ray dye is injected into the artery, allowing the physician to assess the results of the procedure.

Laser Atherectomy is quick, and in many cases, almost painless.

Normally, you'll be awake during the procedure and experience very little, if any, discomfort. The procedure generally takes an hour or two, and many people report relief from leg pain the same day. You can expect to return home to your normal routine with little to no pain, usually on the same day.

What to expect after the Laser Atherectomy procedure:

After treatment, you'll probably be ready to return to your normal routines—your doctor will give you specific instructions.

But there are some key lifestyle changes that will help reduce effects of PAD:

  • Quit smoking
  • Control your diabetes
  • Exercise daily
  • Eat a healthy diet
  • Watch your cholesterol
  • Maintain healthy blood pressure
  1. Yost, M.L., (2011).The real cost of peripheral artery disease. The Sage Group, LLC.
  2. American Heart Association, www.americanheart.org