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My Aching Legs: Peripheral Arterial Disease


Eric Cohen, M.D.

If you have leg pain when you walk that improves when you stop, you may think it’s from being out of shape or a part of aging, but it could be due to a serious condition called peripheral arterial disease.

Peripheral arterial disease, or PAD, is a disease of blood vessels in which arteries carrying blood to the arms and legs become narrowed or clogged; blood flow to the limbs becomes slowed or stopped. PAD is a warning sign for stroke and heart attack, because the process involving the arteries in the limbs also affects the arteries to the brain and heart.

The most common symptom of PAD is painful cramping of the legs or hips during walking, which disappears with rest. Other symptoms include numbness or tingling of the legs, burning pain in the feet or toes, a sore on the leg or foot that does not heal, a cold leg or foot, skin color changes or loss of hair on the legs. In extreme cases of untreated PAD, gangrene can develop, which may require amputation of the foot or leg.

Atherosclerosis, or “hardening of the arteries,” is the most common cause of PAD. PAD also may be caused by blood clots that become lodged in the arteries.

PAD affects 5 percent of people over age 50, or 8 million Americans. Of the 8 million affected, approximately 5 million Americans do not have any systems of having PAD, and only half of those with symptoms are diagnosed and receive treatment.

Risk factors for PAD include:

• Over the age of 50
• Smoking
• Diabetes
• High blood pressure
• High cholesterol
• Being overweight
• Inactive lifestyle
• Family history of heart or vascular problems

Treatment includes lifestyle changes such as regular exercise, losing weight and lowering cholesterol. The most important thing to do is to stop smoking. Additional treatment options include:

• Angioplasty – a small balloon on a thin tube called a catheter is inserted and then inflated to open the narrowed artery.
• Stent placement – a tiny metal cylinder called a stent is left in the artery to keep it open.
• Plaque excision atherectomy – removal of the plaque in the artery using a special catheter to shave away the plaque.
• Laser atherectomy – removal of plaque using pulsating beams of ultraviolet light to vaporize the plaque
• Thrombolytic therapy – clot-busting drugs are given to dissolve the blood clot at the site of blockage.

More invasive treatment options include bypass graft surgery, in which a vein or synthetic graft is used to create a detour for blood flow around the blocked artery. 

About Dr. Cohen

Specializing in vascular care, Dr. Cohen has long been nationally recognized as an expert in interventional cardiology, stroke intervention and limb salvage. He has led extensive research studies, authored numerous medical articles and lectured across the country. Dr. Cohen practices in Flagstaff and the Verde Valley.
To schedule an appointment with Dr. Cohen or any of the cardiovascular physicians at the Heart & Vascular Center of Northern Arizona, call 977 928-WELL. For more information, visit NAHeartCare.com.

About HVCNA:

A partnership between Flagstaff Medical Center (FMC) and Verde Valley Medical Center (VVMC), the Heart & Vascular Center offers a wide spectrum of care. Diagnostic services available through the program’s affiliation with FMC and VVMC include stress testing, nuclear imaging, cardiac and peripheral ultrasound, cardiac Doppler and pacemaker/defibrillator interrogation and programming. When intervention procedures are necessary, cardiac catheterization, balloon angioplasty, stent placement, permanent pacemaker insertion and treatment for peripheral arterial disease are available (including aortic endograft therapy and carotid stenting).



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