New Jersey Peripheral Arterial Disease Treatment

Lifestyle Changes

Often PAD can be treated with lifestyle changes. Smoking cessation and a structured exercise program are often all that is needed to alleviate symptoms and prevent further progression of the disease.

Medication

Medications that lower cholesterol or control high blood pressure may be prescribed. Medication also is available that been shown to significantly increase pain-free walking distance and total walking distance in individuals with intermittent claudication. Other medications that prevent blood clots or the buildup of plaque in the arteries are available as well.

Exercise

Research has shown that supervised regimented exercise programs can improve symptoms of claudication. This should be attempted for at least three months for any occupational or vocational life limiting claudication prior to considering invasive therapies.

Angioplasty and stenting

Interventional radiologists pioneered angioplasty and stenting, which was first performed to treat peripheral arterial disease. Using imaging for guidance, the interventional radiologist threads a catheter through the femoral artery in the groin, to the blocked artery in the legs. Then the interventional radiologist inflates a balloon to open the blood vessel where it is narrowed or blocked. In some cases, this is then held open with a stent, a tiny metal cylinder. This is a minimally invasive treatment that does not require surgery, just a nick in the skin the size of a pencil tip.

Balloon angioplasty and stenting have generally replaced invasive surgery as the first-line treatment for PAD. Early randomized trials have shown interventional therapy to be as effective as surgery for many arterial occlusions, and in the past years, a very large clinical experience in centers throughout the world has shown that stenting and angioplasty are preferred as a first-line treatment for more and more processes throughout the body.

Atherectomy

With this treatment, a tiny catheter is inserted into the artery at the site of blockage that is able to “shave” or “cut” the plaque from the inside of the artery and remove it from the patient.

Testing

Ankle Brachial Index

The ABI is a simple, painless test that compares the blood pressure reading in the arm and ankle. It is a direct measure of fatty plaque buildup in leg arteries and an indirect gauge of plaque accumulations throughout the entire cardiovascular system. This method is entirely non-invasive and completely painless.

The blood pressure in your arms and ankles is checked using a regular blood pressure cuff and a special ultrasound stethoscope called a Doppler. The pressure in your foot is compared to the pressure in your arm to determine how well your blood is flowing and whether further tests are needed.

Because atherosclerosis is a systemic disease, individuals developing plaque in their legs are likely to have plaque building up in the carotid arteries, which can lead to stroke, or the coronary arteries, which can lead to heart attack. Early detection of PAD is important because these individuals are at significantly increased risk, and preventive measures can be taken.

An individual with an ABI of 0.3 (high risk) has a two- to three-fold increased risk of five-year cardiovascular death compared to a patient with an ABI of 0.95 (normal or low risk).

Ultrasound

Sound waves are used to measure blood flow in the arteries and determine whether there is a blockage.

Computed Tomography (CT) Angiography or Magnetic Resonance Angiography

Both tests produce images of arteries; the CT exam uses X-rays, while the MRA does not. For both exams, a patient may be injected with a dye or other contrast agent to make the arteries more visible.

Vascular Disease Testing And Screening

The Vascular Institute offers free ABI screenings. We invite you to schedule your ABI test today so that we can start your peripheral vascular disease treatment tomorrow.

If you do not currently have symptoms that does not mean you are not at risk for vascular disease. If you have risk factors such as:

• Age 65 or older
• Age 50 or older with high cholesterol, diabetes, or smoking history
• Strong family history of heart or vascular disease or aortic aneurysm

If you have symptoms you should consider getting an ABI test to see if they are related to peripheral vascular disease.

Symptoms include:

• Pain in the thigh, calf or buttocks with walking certain distances
• Non-healing wounds on your feet or lower extremities
• Pain in the leg or foot while resting relieved by hanging over the bed

PAD Patient Forms

If you have a PAD appointment, please print and complete the patient forms. Please bring the completed forms to your appointment.