Peripheral Arterial Disease (PAD)
What is peripheral arterial disease?
Your arteries deliver oxygen-rich blood from your heart to other parts of your body. Your peripheral arteries carry blood away from the heart to your arms and legs. The peripheral arteries in your legs are extensions of the largest artery in your body, the aorta. The aorta travels down through your abdominal region and branches off into the iliac arteries of each leg. The iliac arteries further divide into smaller arteries and deliver blood down your legs to your toes.
Healthy peripheral arteries are smooth and unobstructed, allowing blood to flow freely to the legs and provide oxygen, glucose, and other nutrients that your legs need. Typically with age, the peripheral arteries build up plaque, a sticky substance made up mostly of fat and cholesterol. Plaque narrows the passageway within the arteries and causes them to become stiff. Peripheral arterial disease results when the peripheral arteries become too narrow or obstructed and limit the blood flow to the legs. If left untreated, peripheral arterial disease can cause pain or aching in the legs, difficulty with walking, resting pain in the footat night in bed, non-healing sores or infections in the toes or feet, and can lead to limb loss in its most severe form. In addition, it can be associated with other serious arterial conditions leading to heart attacks and stroke.
Causes and Risk factors
- Gender-males are more prone to the condition than females
- Hypertension (high blood pressure)
- High cholesterol
- Lack of exercise
- Family history of vascular problems
Reducing Risk Factors
- Stop Smoking
- Low Fat Diet
- Control High Blood Pressure
- Care for your Feet
- Exercise Daily
There may be no symptoms in the early stages of peripheral arterial disease. Developing symptoms may include discomfort or pain in your legs when walking but no pain when you rest.
Diagnosis of vascular disease begins with a careful medical history, including risk factors and physical exam, followed by non invasive tesing.
Non-Invasive Testing: Non-invasive testing uses state of the art ultrasound technology to evaluate flow, perfusion and pressures within the vessels at rest and with exercise. These procedures are painless (no needles are involved) and can help to determine if blood vessel disease is present, the location, and severity. Exclusively from the results of these tests, the surgeon will determine the need for more invasive testing or procedures to treat vascular disease.
Videos of peripheral Procedures
You can browse some of the videos of procedures that have been carried out by Mr. Sultan at the link below:
- Sultan S Non-operative active management of critical limb ischaemia:initial experience using a sequential compression biomechanical device for limb salvage. Vascular 2008 16(3):130-9
- Sultan et al. A prospective feasibility study of duplex ultrasound arterial mapping, digital subtraction angiography and magnetic resonance angiography in the management of critical limb ischaemia by endovascular revascularisation Ann Vasc Surg 2007 21(4)
- Scheinert D, Peeters P, Bosiers M, O'Sullivan G, Sultan S, Gershony G. Results of the multicenter first-in-man study of a novel scoring balloon catheter for the treatment of infra-popliteal peripheral arterial disease. Catheter Cardiovasc Interv. 2007 Dec 1;70(7):1034-9. PMID: 18044759
- Sultan S, Hynes N. Recent trends in the management of peripheral vascular disease in high risk patients. Heart Wise. 2007: 10(2);21-25.
- Hynes N, Sultan S. Reinforced long saphenous vein bypass graft for infrainguinal reconstruction procedures: case series and literature review. Vascular. 2006 Mar-Apr;14(2):113-8. PMID: 16956481
- O'Sullivan CJ, Hynes N, Sultan S. Haemoglobin A1C (HbA1C) in Non-diabetic and Diabetic Vascular Patients. Is HbA1C an Independent Risk Factor and Predictor of Adverse Outcome? Eur J Vasc Endovasc Surg. 2006 Aug;32(2):188-97.;PMID: 16580235
- Hynes N, Sultan S. The influence of subintimal angioplasty on level of amputation and limb salvage rates in lower limb critical ischaemia: a 15-year experience. Eur J Vasc Endovasc Surg. 2005 Sep;30(3):291-9. PMID: 15939635
- Hynes N, Sultan S. Subintimal angioplasty as a primary modality in the management of critical limb ischemia: comparison to bypass grafting for aortoiliac and femoropopliteal occlusive disease. J Endovasc Ther 2004 Aug;11(4):460-71. PMID: 15298498