Maryvale Cardiology

Peripheral Vascular Center

Peripheral Vascular Disease

The term peripheral vascular disease refers to problems in the major arteries and veins outside of the heart. There are two types of vascular disorders: peripheral arterial disease (PAD) and peripheral venous disorder (please see

Peripheral Arterial Disease (PAD)

PAD refers to diseased peripheral arteries wherein they become either hardened and narrowed with fatty deposits (atherosclerotic plaques) or enlarged and ballooned out (aneurysms). When plaque or aneurysm have developed enough a significant circulatory problem occurs, which can lead to death, stroke, kidney failure and limb loss. Unfortunately, circulatory problems often go undiagnosed due to a lack of symptoms and awareness and may not be discovered until one of these events occurs. That’s why each of the experienced members of Maryvale Cardiology emphasize prevention and early detection of PAD.

Incidence Of Peripheral Arterial Disease (PAD)

Frequent Types of Peripheral Arterial Disease

Carotid artery disease. Narrowing of one or more of the carotid arteries (neck arteries that supply oxygen-rich blood to the brain). When narrowing becomes severe, a stroke can occur. Stroke is the third leading cause of death in America today. Furthermore, stroke survivors are often left with permanent physical disability and mental disorders.

PAD of the kidney arteries. Narrowing of one or more kidney arteries that can cause uncontrolled hypertension or kidney failure. If the blocked arteries are left untreated, kidney failure can lead to end-stage kidney disease and the need for dyalisis.

PAD of the upper and lower extremities. Narrowing of one or more arteries in the arms and legs that can lead to disabling pain, limb weakness, ulcers, and amputation of a limb.

Abdominal Aortic Aneurysm (AAA). It is a "ballooning" of the wall in the abdominal aorta. The majority of people with AAAs have no symptoms. If an AAA ruptures, 80% of patients die within a few minutes due to severe internal bleeding; 20% of patients survive long enough to reach the hospital with many suffering significant complications as result of the initial event. More than 15,000 U.S. residents died last year of AAAs.

Risk Factors of Peripheral Arterial Disease

Risk factors for PAD include high blood pressure, diabetes, smoking, high cholesterol levels, kidney disease, and a family history of PAD.

If you have any of these risk factors, ask your doctor about your risks for PAD. Men are more prone to have PAD, but women are catching up quickly and are certainly not immune, especially if they smoke or have diabetes and kidney disease.

PAD Symptoms

Diagnosing Peripheral Arterial Disease

Diagnosis of PAD can be done through a thorough history and physical exam performed by someone expert in the field. Additional diagnostic tests and procedures are used to assess if a patient has significant PAD and to determine the most effective treatment.

Initial diagnostic tests are non-invasive through the use of ultrasound-based methods. If these tests indicate the need for more information, then additional diagnostic tools are used such as computerized tomography (CT) scans and magnetic resonance imaging (MRI). Ultimately, further information can be obtained with invasive arteriograms which involve placement of a long and narrow tube (catheter) into an artery and the injection of dye to obtain an accurate picture of the arteries.

Treatment of PAD. The Maryvale Cardiology Difference

The Peripheral Vascular Clinic at Maryvale Cardiology uses a patient-oriented approach in a “one-stop-shopping”. We offer expertise across the entire spectrum of non-invasive diagnosis, medical therapy, and interventional procedures. Vascular surgery is provided by expert consultants that work closely with our physicians.

Interventional Treatments For PAD

In many cases, VIA Interventional Radiologists can open blocked or narrowed blood vessels caused by peripheral arterial disease or other conditions. For example, in some patients, high blood pressure is caused by blockage to the artery to the kidney, a condition known as renal vascular hypertension. Maryvale Cardiology physicians can often treat blocked blood vessels without surgery. In most cases, hospitalization and general anesthesia are not required. There is no surgical incision – just a small nick in the skin – and no stitches are needed. Often, patients may return to normal activity shortly after the procedure.

Your Maryvale Cardiology physician will determine the treatment that best serves you and your condition. If you are a candidate for a minimally invasive Interventional Treatment, your physician may recommend Angioplasty or Stenting. Maryvale Cardiology physicians have a vast experience in the minimally invasive treatment of vascular disease.

Angioplasty

In this technique, the interventional radiologist inserts a very small balloon attached to a thin tube (catheter) into a blood vessel through a small nick in the skin. The catheter is threaded under X-ray guidance to the site of the blocked artery. The balloon is inflated to open the artery.

Stent

Sometimes, a small metal scaffold / tube, called a stent, is inserted to hold the blood vessel open. Between 70 percent and 90 percent of angioplasty procedures use a stent, a hollow thin-walled wire mesh tube, to keep the vessel open after widening it. Otherwise, because arteriosclerosis is an ongoing disease, more plaques might form and again limit blood flow. The stent is placed onto the balloon and pressed firmly against the artery wall when inflating it. The balloon then is deflated, leaving the stent in place to act as a scaffold.