Peripheral arterial disease
What is peripheral arterial disease?
Peripheral arterial diseases occur in various forms that damage the arteries, which deliver blood from the heart throughout the body. The most common types of peripheral arterial disease include blood clots or calcium that block blood flow and prevent oxygen from reaching tissue. This can cause pain, sores, or even dead tissue that can lead to strokes and heart attacks.
Some patients experience pain or heaviness in their legs while walking, which prevents them from enjoying their lives. But only a small number of people will experience these more extreme and painful symptoms.
A physician can perform a physical exam to determine whether a patient has peripheral arterial disease, including measuring blood pressure or performing an ultrasound or an MRI.
Interventional radiologists are board-certified physicians who deliver minimally invasive treatments with less risk, less pain, and less recovery time than traditional surgery to treat peripheral arterial disease.
Thrombolysis delivers medication slowly, over 12-24 hours, to a blood clot through a thin tube that is inserted next to or within the clot. This treatment is usually enacted in an emergency because the body has not had enough time to respond by growing new blood vessels to bypass the blockage. The patient is hospitalized during the treatment and will be watched by nurses and doctors in the intensive care unit. Often, the clots will be dissolved but the artery will still be narrowed and additional treatments may be required.
When a blood clot suddenly blocks blood flow, a treatment known as a thrombectomy will remove the clot from the body using various medical tools that can draw out, pull out, or vaporize the clot. The method chosen depends on the preference of the physician and the location of the clot.
Angioplasty uses inflatable devices called balloons to open up narrowed arteries. Various types of balloons are used in different situations, including balloons that stretch arteries open, metal-edged balloons that cut and break up calcium deposits, and drug-coated balloons that can prevent scarring and future narrowing of the artery.
During angioplasty (left), the interventional radiologist guides a catheter with a tiny balloon tip through the blood vessels into the blockage. The balloon is inflated to widen the artery, which restores blood flow. Sometimes the doctor will place a stent (a tiny mesh tube) in the artery to help keep it open. See Stenting, below.
Stenting uses small metal tubes to hold open narrowed arteries that are closing. Various types of stents are used, including two main categories: bare metal and drug-eluting.
Patients who receive stents also need to be on clot-preventing medications related to aspirin called “anti-platelets” that reduce the chance of clots forming inside the stent.