Peripheral Vascular Disease
Heart & Vascular Care at St. Helena Hospital
St. Helena Hospital’s top-rated Heart &
Vascular Center serves the entire North Bay area. Highly trained
cardiologists, cardiovascular surgeons and staff – along with a state-of-the-art
cardiac catheterization lab, surgery facilities and cardiac rehabilitation
program – provide care that has won numerous quality awards.
St. Helena Hospital
is located California’s beautiful Napa Valley.
If you have questions about or symptoms of PVD, talk to your doctor. If you need
a doctor,
click here or call 1-800-540-3611 for a referral.
Peripheral vascular disease: Screening can save lives
If untreated, peripheral vascular disease raises the risk for heart
disease and stroke, as well as for amputation or serious leg damage.
A simple test on your arms, legs and ankles could give you a heads-up on
heart and vascular disease.
It’s called an ankle brachial index, or ABI. It’s used to detect poor blood
flow in your legs, which can be a symptom of peripheral vascular disease (PVD),
a narrowing of the arteries that is linked to heart disease and stroke.
What is peripheral vascular disease?
- PVD, also known as peripheral arterial disease or PAD, refers to
diseases of blood vessels outside the heart and brain, according to the
American Heart Association.
- PVD happens when arteries leading to the arms, legs, feet, kidneys or
stomach build up plaque and get narrow.
- The symptoms of PVD are:
- A cramping pain and fatigue in your legs and buttocks that goes away with
rest
- Chronically cold toes
- Numbness or tingling
- Changes in color of legs or feet
- Sores on legs or feet that are slow to heal
Pain in the legs is usually the first sign – a signal that not enough
oxygen-rich blood is getting to your legs during exertion, says Nia Lendaris,
RN, MSN, cardiovascular service line coordinator at St. Helena Hospital.
Because your muscles need less oxygen at rest, the pain stops when the
physical activity stops.
As the disease progresses, you might also notice pain at rest, she says,
along with one or more of the other symptoms. Some people, she warned, have
no symptoms so everyone should be screened if they are at risk.
Why screening is important
Although the symptoms of PVD usually show up in the legs, the problem is
rarely confined to that area.
PVD usually develops as a result of atherosclerosis, the buildup of fatty
deposits in the linings of vascular walls, according to the
Society of
Interventional Radiology (SIR). People with PVD often have
the same fatty buildup in other arteries too, such as those in the heart and
brain. That raises their risk for heart attack and stroke. Left untreated,
PVD also can result in loss of feeling in the leg, gangrene and amputation.
That’s why the American Diabetes Association and SIR
recommend using the ABI to screen people at high risk for the disease.
During the ABI test, a doctor uses a special stethoscope to compare the
blood pressure in the feet and arms. An ABI test can alert your doctor to
decreased circulation in your legs. He or she might also order other tests,
such as an imaging test to check blood flow.
Treatment and prevention
The first line of treatment and prevention for PVD is changing your
lifestyle to lower your risk for heart disease and stroke.
If you smoke, the highest priority for changing your lifestyle is to
quit.
You should also make other lifestyle changes:
- Control diabetes and high blood pressure
- Lower cholesterol levels
- Begin a regular exercise program, such as walking
- Choose a healthy, low-fat diet
Doctors use medications to treat PVD by treating risk factors. Anti-platelet
agents like aspirin and cholesterol medicines, medications to control your
blood pressure and recommending exercise are often used. When these
treatments don’t work, procedures using catheters, balloons, and stents as
well as surgery can open clogged arteries.
Ask your doctor about an ABI screening or call 1-800-540-3611 for a referral
to a physician who offers ABI screening in the office or at the hospital.
Ask your doctor
To help control your risks for PVD and associated problems, ask your doctor
the following:
- If I’m at risk for PVD, do I need an ankle brachial index (ABI) screening
or other test?
- How often should I be tested?
- What should I do if my blood pressure, blood sugar or cholesterol levels
are too high?
- If I have PVD, what steps do I need to take to treat it?
Reduce your risk: Stop smoking the Napa Valley way
Smokers are at greatly increased risk for PVD. The
Smoke-Free Life program
at St. Helena Center for Health can help you quit for good. It is offered
now as a seven-day onsite program at St. Helena Hospital and will soon be
available as a six-week outpatient program. This medically sound, proven
program provides medical supervision, symptom management, nutrition and
education. For more information call 1-800-358-9195.
PVD: Are you at risk?
Take this short quiz to see if you could be at risk for peripheral vascular
disease (PVD).
| 1. Are you age 50 or older? |
Yes No |
| 2. Do you smoke? |
Yes No |
| 3. Do you have diabetes? |
Yes No |
| 4. Do you have high blood pressure? |
Yes No |
| 5. Do you have high cholesterol? |
Yes No |
| 6. Do you have a family history of heart disease or
vascular (blood vessel) disease? |
Yes No |
| 7. Are you overweight? |
Yes No |
| 8. Are you sedentary with little or no exercise? |
Yes No |
If you answered yes to even one of these questions, you could be at risk for
PVD. So be sure to share your quiz results with your doctor.
Weight loss is key to good health
Maintaining a healthy weight reduces your risk for many health problems
including PVD. If you’ve tried everything else, you should investigate
Transformations™, St. Helena Center for Health’s 11-day onsite program that
combines medical, psychological, nutritional and educational components to
get your weight under control. Studies show this program improves all major
health indicators within nine days, and teaches participants how to cook,
eat, exercise and live for health and weight management. For more
information call 1-800-358-9195.
Vascular surgery: when conservative treatment isn’t enough
When more aggressive treatment for PVD is necessary, one of three different
options may be recommended:
Angioplasty and Stenting
Angioplasty and stenting is not as invasive as surgery. In an angioplasty,
your physician inserts a long, thin, flexible tube called a catheter into a
small puncture over an artery in your arm or groin. Using a video screen,
the doctor guides the catheter to the blocked area. Then a special balloon,
which is attached to the catheter, is inflated and deflated several times.
The balloon pushes the plaque in your artery against your artery walls,
widening the vessel. In some circumstances, your vascular surgeon may then
place a tiny mesh-metal tube, called a stent, into the narrowed area of your
artery to keep it open. The stent remains permanently in your artery. After
this procedure, blood flows more freely through your artery.
Plaque Excision
Plaque excision
is a minimally invasive procedure performed through a tiny puncture site in
the leg or arm.
The SilverHawk® technology uses a tiny rotating blade to shave away plaque
from inside the artery. The SilverHawk catheter is inserted into the body
through a small puncture site and is advanced through the artery to the site
of the blockage.
Once the catheter is at the site of the blockage, a tiny rotating blade is
activated. The physician advances the catheter through the lesion, shaving
plaque off of the artery walls. The plaque collects in the tip of the
catheter and then is completely removed from the body. The physician may
need to repeat these steps until enough plaque is removed to restore normal
blood flow to the legs.
Source: www.foxhollowtech.com
Bypass Surgery
Bypass surgery creates a detour around a narrowed, or blocked, section of a
leg artery. To create this bypass, your vascular surgeon uses one of your
veins or a tube made from man-made materials. Your vascular surgeon attaches
the bypass above and below the area that is blocked. This creates a new path
for your blood to flow to your leg tissues.
In extreme cases, especially if your leg has gangrene, your surgeon may
recommend amputating your lower leg, foot or toe.
Amputation is a treatment
of last resort. Vascular surgeons usually only perform it when the
circulation in your leg is severely reduced and cannot be improved by other
methods. More than 90 percent of patients with gangrene who are seen by
vascular specialists can avoid amputation or have it limited to a small
portion of the foot or toes.
Source:
www.VascularWeb.org
Read Ron Cia’s Story:
Recovering from PVD
