Peripheral Aterial Disease and Leg Pain

What is peripheral vascular disease?

Leg pain that results from peripheral vascular disease, also called peripheral artery disease, peripheral arterial disease, or "PAD," occurs when blood supply to the legs is reduced due to the build up of fatty deposits, or plaques, within the lining of the blood vessels. This build up of plaque, called atherosclerosis, narrows ("occludes") the pathway through the blood vessel, making it more difficult for blood to flow through.

Typically, people who have PAD may feel it in their legs when walking or climbing stairs. Symptoms may include pain, numbness, aching, cramping or heaviness in the leg muscles, and cramping in the buttocks, thighs, calves, and feet. Symptoms usually ease after resting.

These symptoms, called intermittent claudication, are the body's response to a decreased blood supply, called arterial insufficiency. During physical activity, your muscles need more oxygenated blood. If your blood flow is limited due to narrowed or blocked vessels, your muscles won't get enough blood. When the demand for blood is lessened during rest, the pain goes away.

According to the National Heart Lung and Blood Institute, only about 10% of people with PAD experience leg pain. Commonly, people can have PAD without knowing it. However, people who do have PAD also are at higher risk for coronary artery disease as well.

Risk factors for PAD include:

• Age
• Smoking
• Diabetes
• High cholesterol
• High blood pressure
• Obesity
• Physical inactivity

Other symptoms of PAD include:

• Weak or absent pulses in the legs or feet
• Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
• A pale or bluish color to the skin
• A lower temperature in one leg compared to the other leg
• Poor nail growth on the toes and decreased hair growth on the legs
• Erectile dysfunction, especially among men who have diabetes

Your Treatment for Peripheral Artery Disease at Baptist Cardiovascular Center

At Baptist, interventional cardiologists and vascular surgeons, treat patients with peripheral artery disease. These physicians use a number of state-of-the art diagnostic tests to determine the severity and location of your disease and the recommended treatment options. Your physician will also closely monitor your heart, since the presence of PAD puts you at higher risk for heart disease.

Get to know physicians on staff at Baptist. Watch their video profiles:

• W. Stewart Horsley, MD
• Chris Waterer, MD

Tests You May Need

To fine tune your diagnosis, your physician may perform any number of tests, including the following.

Doppler Ultrasound

A doppler ultrasound uses sound waves to show whether a blood vessel is blocked. This test uses a blood pressure cuff and special device to measure blood flow in the veins and arteries of the limbs. A Doppler ultrasound can help find out how severe P.A.D. is. Source: National Heart Lung and Blood Institute

Treadmill Test

For this test, you walk on a treadmill. This shows whether you have any problems during normal walking, how severe your symptoms are and what level of exercise brings them on. Source: National Heart Lung and Blood Institute

Magnetic Resonance Angiogram

A magnetic resonance angiogram (MRA) uses magnetic and radio wave energy to take pictures of blood vessels inside your body. This test can find the location of a blocked blood vessel and show how severe the blockage is. Source: National Heart Lung and Blood Institute

Arteriogram

For this test, dye is injected through a needle or catheter (tube) into an artery. After the dye is injected, an x ray is taken. The pictures from the x ray can show the location, type, and extent of the blockage in the artery. Source: National Heart Lung and Blood Institute

Recommended Treatment

Depending on what your physician discovers during any diagnostic tests you may receive, your treatment will range from medication, to a procedure in our Cath Lab to surgery. Baptist offers all the following treatment options:

Medical Management

There are a number of drugs, such as aspirin and Plavix (anticoagulants), used to treat patients with peripheral artery disease. These medications help prevent clotting.

Angioplasty

In some cases, patients may be able to undergo a procedure, called angioplasty, in Baptist's Cath Lab. During angioplasty, your doctor will make a small opening in a blood vessel, usually in your groin, through which he or she will thread a thin, flexible tube (called a catheter) with a deflated balloon on its end. Once the tube is in the area of the blood vessel that needs treatment, your physician will expand the balloon inside the artery to compress plaque and widen the passage. Angioplasty improves blood flow through the vessel. The balloon is deflated and taken out along with the catheter. (Source: National Heart Lung and Blood Institute)

Physicians who perform angioplasty in the Cath Lab are Drs. de Grijs, Horsley, and Waterer.

Vascular Surgery: Bypass Grafting

For some patients, surgery to restore blood flow to an area affected by a blocked artery may be recommended. In this procedure, called bypass grafting, the doctor uses a blood vessel from another part of your body or a man-made tube to make a graft. This graft bypasses (goes around) the blocked part of the artery, which allows blood to flow around the blockage. This is similar to bypass surgery sometimes done for patients with heart disease to bypass blocked coronary vessels. The procedure is typically done under general anesthesia, and usually takes about one and a half to two hours. Afterwards, patients generally have a hospital stay that lasts two days. Bypass surgery may be performed in these vessels:

• Aorta -- the main artery that comes from your heart
• Iliac artery -- in your hip
• Femoral artery -- in your thigh
• Popliteal artery -- behind your knee
• Tibial and peroneal artery - in your lower leg
• Axillary artery -- from your armpit

Physicians who perform bypass grafting surgery include Drs. de Grijs, Horsley, and Roy. Watch their video profiles.
W. Stewart Horsley, MD
Rishi A. Roy, MD

Get help for peripheral artery disease at Baptist

If you would like to become a patient at Baptist, the first step is seeing one of our physicians. You can request a referral by calling the Baptist Heart at 601-968-1966, or requesting an appointment online.

About Baptist Heart

Baptist has earned several prestigious certifications, accreditations and awards for our care of patients with cardiovascular conditions.
See our full list of certifications, accreditations and awards.

Preventing Heart Disease and Stroke

If you have a family history of heart disease and/or stroke, you may be interested in our low cost screening programs. These screenings are available year round and provide results you can have sent to your personal physician.