PAD and Limb Ischemia

Some 12 million Americans have peripheral arterial disease (PAD), blocked blood vessels in the legs that can cause discomfort or pain when walking. However, 75 percent of these people have no symptoms. PAD can also be a sign that you have blocked blood vessels in other parts of your body. PAD also raises your risk of having a heart attack or stroke. Left untreated, PAD can lead to serious issues, including amputation and disability.

PAD is the partial or complete blockage of blood flow through the arteries in your limbs, usually your legs. It occurs when plaque (a substance made of cholesterol, calcium, and fibrous tissue) builds up in your body's blood vessels. This is called atherosclerosis, or "hardening of the arteries." When arteries become blocked or narrowed, blood can't flow properly and the muscles of your legs don't receive enough oxygen. This can cause discomfort or pain in your legs while walking called claudication.

A more serious type of PAD is called limb ischemia. Limb ischemia is a severe blockage in the arteries in your legs. This can cause extreme blockage and significantly reduce blood flow in your legs. Limb ischemia can cause severe pain in legs, feet, or toes even when you're at rest. The poor circulation in your legs may result in you developing sores or wounds that won't heal.

The physicians at Sentara Vascular Specialists are experts in diagnosing and treating PAD and limb ischemia. Although surgery is an effective treatment approach, the physicians at Sentara Vascular Specialists consider minimally invasive approaches first. Our specialists will work with you to determine the best treatment approach for you.

Revascularization, or reopening the blocked vein or artery, is the primary goal of treating PAD and limb ischemia. Because the majority of cases are in the lower legs, our physicians specialize in a variety of techniques for lower extremity revascularization to restore blood flow to the legs and feet. The types of lower extremity revascularization performed by Sentara Vascular Specialists include:

  • Balloon Angioplasty and stenting, a balloon topped catheter inserted through your skin into a vein. The balloon is inflated to push back the plaque and help reopen the vein, and then a stent (a tiny mesh metal flexible tube) is placed in your vein to hold back the plaque and keep the vein open;
  • CliRpath Laser Procedure, a catheter inserted into your vein releases laser energy destroying the plaque and reopening the vein;
  • Silver Hawk / Fox Hollow technology, a device with a tiny blade that shaves away the plaque to reopen the vein;
  • Subintimal Angioplasty, a catheter is passed through the blocked artery creating a new passage for blood to flow.

Because PAD is one of the most common reasons for amputation, Sentara Vascular Specialists offers amputation prevention and amputation rehabilitation programs. The goal of our amputation prevention program is to reduce the incidence of amputation. Working closely with you, our specialists perform a noninvasive evaluation, work with podiatry for proper shoe fitting, and perform minimally invasive angioplasty to reopen the proper blood flow to your foot.

Our amputation rehabilitation program works with people who have lost limbs as a result of disease or trauma. Meeting every other Wednesday, our program partners participants with one of our specialists, a licensed social worker, and a physical therapist dedicated to persons who have lost limbs or have prosthetic devices. Our rehabilitation team works with persons who have lost limbs or those with prosthetic devices to assist them in limb care; transfer training; gate training; maintaining a prosthetic device; coping with anxiety depression, and self-esteem; maximizing independence; and enhancing skills for daily living. The program lasts for six to seven months, depending on the individual.


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