Peripheral Arterial Disease

with Anne Bartel, M.D., and James Beres, M.D., Interventional Radiology, Columbia St. Mary’s

Posted: Sept. 1, 2005

Q: What is Peripheral Arterial Disease?

A: Peripheral arterial disease (PAD) is a plaque build-up in arteries other than the heart or brain. Over time, the plaque hardens and begins to narrow the arteries, which prevents oxygen from freely flowing through the blood stream. Most frequently, PAD occurs in the lower extremities, but according to Dr. Anne Bartel “PAD affects all arteries. If you have PAD, you often are at risk for other vascular diseases such as coronary artery disease as well.”

Dr. James Beres agrees that PAD is often not a self-contained disease. “Peripheral vascular disease is a marker for other conditions such as heart disease, stroke, abdominal aortic aneurysm, diabetes, and high blood pressure or high cholesterol,” he says.

James Beres, M.D., Interventional Radiology, Columbia St. Mary’s "PAD is a marker for other conditions such as heart disease, stroke, abdominal aortic aneurysm, diabetes, and high blood pressure or high cholesterol."

Q: How is PAD different from PVD?

A: Peripheral arterial disease (PAD) and peripheral vascular disease (PVD) are the same condition. It may also be referred to as arteriosclerosis of the extremities, which means a hardening and narrowing of the arteries that supply blood to the legs and feet.

Q: Who is affected?

A: PAD affects nearly 20 percent of Americans over the age of 65. Risk factors include a personal health history of heart disease, obesity, hypertension, high cholesterol, smoking and a sedentary lifestyle.

Q: What are the symptoms?

A: “PAD causes angina of the legs,” describes Dr. Bartel. “Similar to pain from narrowed arteries in the heart, the muscles in your legs hurt because they are starved for oxygen.” Pain from PAD usually occurs during walking and disappears when activity ceases. In serious cases, pain may be present even at rest. Other signs of PAD include cramping in the calves, coolness in the legs or feet and slow-healing sores.

Q: What are the risks?

A: PAD can lead to open sores, ulcers, gangrene or worse: “If left untreated or uncontrolled, PAD can lead to complications resulting in amputation,” warns Dr. Beres.

Q: How is it treated?

A: As interventional radiologists, Drs. Bartel and Beres treat PAD with minimally invasive catheter techniques such as angioplasty and stents. Depending on the severity, some cases may not require any treatment and others may reduce symptoms through lifestyle modification such as smoking cessation, weight loss, and exercise.

Q: How is it diagnosed?

A: Because about 50 percent of those affected with peripheral vascular disease never have symptoms, Drs. Bartel and Beres stress the importance of a simple screening, which includes measuring the blood pressure in the arm and ankle. “The blood pressure in your leg should be equal to or greater than the blood pressure in your arm. If it’s not, that’s a clue that there may be a blockage in your lower body,” says Dr. Bartel.

“Legs for Life” is a national screening program sponsored by the Society of Interventional Radiology. This free screening is offered by Columbia St. Mary’s. Call 414-326-1745 for information and to learn if you qualify for the “Legs for Life” screening. You may also contact your health care provider for PAD screening, which may be followed up with other non-invasive diagnostic tests such as MR or CT angiography.

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