Vascular Solutions

Peripheral Artery Disease - Lower Extremity (Leg) Artery Disease With Potential To Progress To Gangrene

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Hardening of the arteries also known as atherosclerosis is one of the major disorders afflicting individuals typically over the age of 50. It is a problem that manifests thorough out the body and can result in heart attacks, strokes, gangrene of a leg, or difficulty with walking. Walking problems are often described as pain in the calf, thigh or buttock during walking that are relieved with a short period of rest. Risk factors for atherosclerosis include smoking, diets high in fats, sedentary life styles, high blood pressure, diabetes, and family history.

Many patients who suffer from atherosclerosis of the legs have difficulty separating this from other causes of walking problems. These other causes can include arthritis, back disease, inflammation of nerves, and shortness of breath. Certain key features best distinguish symptoms, related to atherosclerosis of the leg. In particular, the burning or cramping of the calf, thigh, or buttock should occur exclusively with walking and relief occurs with a short rest period. These symptoms are often progressive over many years and can result in significant limitations in ones quality of life. Hardening of the arteries that impinges upon the ability to walk is referred to as claudication. It historically is related to Emperor Claudius who limped from narrowing of the arteries in his legs.

Narrowing of the arteries in the leg can also result in pain or wounds of the feet. In fact a very common presentation for patients in the later stages of this disorder is the development of gangrene. A common misconception among many lay people is that once gangrene has set in amputations are the only solution. This could not be farther from the truth.

Treatment of narrowing of arteries afflicting any area of the body is dependent on the severity of symptoms. Quite often lifestyle changes are adequate to improve the range of activities that a patient may participate in with significant improvements in self-image and confidence. This should include an exercise program and the cessation of smoking. On occasion some physicians may try a medication that helps blood flow through blood vessels. These are occasionally helpful but the most significant improvements are derived from quitting smoking and an exercise program tailored to the patients requirements

Occasionally these lifestyle changes are not adequate or the patient has more significant problems with non healing wounds or gangrene and can require additional therapy. These patients are best studied using noninvasive tests in a vascular laboratory to determine the extent and location of the blockages in the arteries. Blood pressures are measured in the leg and compared to the arm to allow a measure of the severity of reduced blood flow in the patient’s leg. On this basis a physician and a patient can determine the next appropriate step in treatment.