Peripheral Artery Disease
Peripheral artery disease (PAD) refers to diseases of the blood vessels located outside the heart or brain. Similar to CAD, PAD is primarily caused by atherosclerosis, where fatty deposits (plaque) build up on the artery walls and reduce blood flow. PAD can happen in any blood vessel outside the heart or brain, but it occurs more often in lower limbs. For PAD that occurs in the lower limbs, it is referred to as lower extremity peripheral artery disease (LEAD). People who smoke or have diabetes have greater risk of developing PAD/LEAD. Other risk factors include obesity, hypertension, high cholesterol, family history of peripheral artery disease, heart disease or stroke and high levels of homocysteine, among others.
Treatment for Lower Extremity Peripheral Artery Disease
Similar to those for CAD, treatments for LEAD include medications, traditional open surgeries, and minimally invasive interventional procedures. Medications can help control risk factors such as high blood sugar, hypertension and high cholesterol. In some cases of very severe LEAD, open surgeries are necessary, such as endothelial dissection (in which process the physician makes a small incision to expose the damaged artery and then removes any substances that impede blood flow) and bypass surgery (in which process the physician takes a section of healthy blood vessel from another part of the body and uses it to connect the healthy artery across the narrowed portion of the artery). Percutaneous interventional treatment is an alternative method for the treatment of LEAD, and is becoming the preferred choice of patients and physicians for the treatment of LEAD, because it generally causes fewer complications, allows faster recovery, and is relatively cheaper as compared to open surgeries. Percutaneous transluminal angioplasty (PTA) is a percutaneous interventional procedure to open up blocked peripheral arteries, allowing blood to circulate unobstructed. In a PTA procedure, the physician inserts a balloon-type catheter into an artery in the patient's groin or arm, and then inflates the balloon several times to push the fatty deposits against the artery wall. With the help of X-ray, the physicians can make sure the vessel is opened. When blood flows freely through the artery, the balloon catheter will be taken out. Scaffolds including bare metal scaffolds (BMS), drug-eluting scaffolds (DES) and bioresorbable scaffolds (BRS) may be placed within the peripheral artery to keep the vessel open.