Peripheral Vascular Revascularization

The term peripheral vascular disease is commonly used to refer to peripheral artery disease (PAD), meaning narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain. PAD is a form of arterial insufficiency, meaning that blood circulation through the arteries (blood vessels that carry blood away from the heart) is decreased.

Nearly half of all people with peripheral artery disease do not experience any symptoms. For patients with symptoms, the most common symptoms are intermittent claudication (arm or leg pain that worsens with exercise and goes away with rest) and rest paint in the legs (occurs when patient is lying down, face up). Other symptoms and signs may include:

• Numbness of the legs or feet
• Weakness and atrophy (diminished size and strength) of the calf muscle
• A feeling of coldness in the legs or feet
• Changes in color of the feet; feet turn pale when they are elevated, and red in dependent position
• Hair loss over the top of the feet and thickening of the toenails
• Poor wound healing in the legs or feet
• Painful ulcers and/or gangrene in areas of the feet where blood supply is lost (typically the toes)

Your doctor is likely to ask you a number of questions if you are are suspected to have peripheral vascular disease and they are considering treatment. Be prepared to answer the following questions:

• When did you first begin experiencing symptoms?
• Are your symptoms continuous or occasional?
• Do your symptoms get worse when you exercise?
• How severe are your symptoms?

Angioplasty or bypass surgery is used to treat peripheral vascular disease.

• Angioplasty. In this procedure, a small hollow tube (catheter) is threaded through a blood vessel to the affected artery. There, a small balloon on the tip of the catheter is inflated to re-open the artery and flatten the blockage into the artery wall. This stretches the artery open to increase blood flow.
• Bypass Surgery. Your doctor may create a graft bypass using a vessel from another part of your body or a blood vessel made out of synthetic fabric. This technique allows blood to bypass the blocked artery.