Peripheral Artery Disease
As many as 12 million Americans have Peripheral Artery Disease, or PAD, which is associated with the risk of heart attack and stroke, and many people know nothing about it. Estimates suggest that fewer than 2 million people are diagnosed each year, and fewer than 700,000 treated. PAD is a narrowing of the blood vessels that supply your legs, feet and arms with fresh blood. In PAD, fatty deposits line the walls of blood vessels. This causes blockages and can slow the flow of blood to these vital areas. Click here to view an interactive educational PAD workbook.
Treatment for PAD focuses on reducing symptoms and preventing further progression of the disease. In many cases, lifestyle changes, exercise and medications are enough to accomplish these goals. When these steps do not suffice, Methodist specialists have several treatment modalities at their disposal:
Peripheral Revascularization Techniques
The techniques listed below allow treatment of blockages with more rapid patient recovery compared to surgery:
Trans Radial Angiogram
This technology allows cardiologists to perform an angiogram through the wrist's small, radial artery instead of the groin. With this treatment, post-procedure bleeding risks and reduced, and patients are up and around soon after the procedure, instead of required prolonged bed rest.
In this procedure, the doctor inserts a catheter into a blocked or narrowed artery. A tiny balloon at the tip of the catheter is inflated to push plaque against the artery's walls, widening the path for blood flow.
Stents are small steel mesh tubes placed inside of arteries to keep them open and maintain blood flow. They are used during more than 70 percent of angioplasty procedures. Methodist also uses innovative, drug-eluting stents which are coated or medicated stents that can reduce scar tissue. Less scar tissue reduces the chance for restenosis, or renarrowing of the artery.
Atherectomies remove plaque from inside of an artery. In rotational atherectomy, the tip of a catheter is fitted with a rotating blade shaves plaque into tiny pieces that can be carried away. With directional atherectomy, a small cutting device is used to cut plaque away from the artery.
Surgical procedures are generally reserved for cases in which there is considerable risk to tissues or for cases where PAD is directly threatening a patient’s lifestyle or ability to work.
Abdominal Aortic Aneurysm Repair
An abdominal aortic aneurysm occurs when the wall of the abdominal aorta balloons and can be life-threatening when they rupture, allowing a large amount of blood to enter the abdominal cavity. Ruptured aortic aneurysm is the 10th leading cause of death in adults in the United States: an estimated 15,000 Americans die each year from this disease. Because abdominal aortic aneurysms often develop slowly and without symptoms, the condition frequently goes undetected and untreated until it is too late. Yet, simple screening procedures can allow the early diagnosis and treatment of the condition.
At Methodist Hospitals, our collaborative team of cardiologists, surgeons and nurses offers a new, minimally invasive treatment for patients with abdominal aortic aneurysms as an alternative to traditional open abdominal surgery. This new procedure, endovascular repair, combines angioplasty and stent techniques and uses a catheter to reach into the aorta, restoring blood flow and reducing the pressure of the aneurysm as well as the threat of rupture. This procedure requires a significantly shorter hospital stay than traditional open surgery.
Aortic aneurysms are most common after 60 years of age and men are five times more likely than females to be affected. Approximately 5% of men over age 60 develop an abdominal aortic aneurysm. The United States Preventive Services Task Force recommends screening the following individuals: men aged 65 to 75 years who have ever smoked, women 60 to 85 years old with cardiac risk factors, men and women older than 50 years with a family history of AAA.