Peripheral Artery Disease (PAD) Program
MidMichigan’s specialized PAD Program is dedicated to the advanced management and treatment of peripheral artery disease (PAD). PAD is a life threatening condition caused by the narrowing of your arteries to your legs. Fatty buildup, called plaque, clings to your artery walls, restricting blood flow to your legs. Atherosclerosis, one cause of PAD, is a process where cholesterol and scar tissue build up to clog blood vessels. This is sometimes referred to as “hardening of the arteries.” Blood clots are another cause of PAD.
Program patients can benefit from the expertise of an experienced team of multidisciplinary specialists. These include from left to right, Invasive Cardiologist Abraham Salacata, M.D.; Vascular Surgeon Constantinos Constantiou, M.D.; Interventional Cardiologists Andrzej Boguszewski, M.D., and Rodney Diehl, D.O.; and Interventional Radiologist Shengfu Wang, M.D.
PAD Program Goals
- Educate and counsel patients with PAD about their condition and how it is treated.
- Prevent worsening of the disease.
- Analyze the medical history and other circumstances of the patients suffering from PAD to determine the best treatment options.
- Streamline referrals and treatment to our clinical partners when necessary.
- Provide smooth transitions and coordinate care between multiple disciplines, including social work, pharmacy, PAD rehab, nutrition services, as well as primary care and specialty providers.
- Counsel patients on self-care behaviors (i.e. smoking cessation, walking programs).
- Improve the overall quality of life for PAD patients.
- Promote clinical research opportunities.
Many people who have PAD do not experience symptoms or mistake their symptoms for something else. Symptoms may include:
- Leg muscle tiredness, heaviness or cramping
- Toes or feet that look pale, discolored or blue
- Leg or foot pain that disturbs sleep
- Sores or wounds on toes, feet or legs that heal slowly or not at all
- One leg or foot that feels colder than the other
- Thick or yellow toenails that aren’t growing
- Shiny skin or loss of hair on leg(s)
- Weak or no pulse in leg(s) or feet
PAD Risk Factors
- Chronic Kidney Disease
- High Cholesterol and/or High Blood Pressure
- Age (Greater risk over age 50)
- Overweight and Inactive
- Family History of Heart or Vascular Disease
Patients with multiple risk factors or who are experiencing PAD symptoms, the following tests may be performed:
Ankle Brachial Index (ABI) - measures the ratio between the blood pressure in your ankle and the blood pressure in your arms.
If your ABI is abnormal, you may require additional testing. Tests may include:
- Arterial Doppler Study - uses ultrasound imaging to help evaluate blood flow through your blood vessels and identify blocked or narrowed arteries.
- CT Angiography - injects dye into your blood vessels, which allows your doctor to view blood flow through your arteries as it happens. (This test may be altered by diabetes causing a false negative.)
Treatments for PAD may include:
- Lifestyle changes
- Medications may be prescribed to lower cholesterol, control high blood pressure, or prevent plaque build-up and blood clots.
- Statins - are a lipid lowering medications which have been found to reduce the risk of cardiovascular disease by reducing "bad" cholesterol. There are many types available for your provider to prescribe.
- Reduces plaque in leg arteries
- Stabilizes plaque to reduce the risk of sudden rupture that causes stroke and heart attack
- Improve arteries overall function
- Side effects:
- May cause liver damage (requires regular laboratory testing)
- May cause muscle pain, cramps, or injuries
- May lead to kidney failure in severe cases
- Aspirin - is sometimes used to treat or prevent heart attacks, strokes, and chest pain. It should be used for cardiovascular conditions only under the supervision of a physician or advanced practice provider.
- Proven to decrease the risk of heart attack and stroke in patients with PAD
- Reduces the risk of clotting in the blood stream
- Side effects:
- Most common problem is upset stomach
- Patients who have stomach ulcers may not tolerate aspirin well
- PAD Procedures - if lifestyle changes and medications are not enough, physicians may be able to open blocked vessels by performing the following:
- Angioplasty - a minimally invasive procedure where a balloon is inflated inside a blocked artery to restore blood flow. A stent may be placed in the artery to keep it open.
- Atherectomy - a minimally invasive procedure using a medical device to help open blocked arteries.
- Bypass surgery - a surgical procedure that uses a blood vessel or synthetic tube to bypass blockages in the artery.
- A foot-care program might also be prescribed to prevent infection.
Request An Appointment
If you have multiple risk factors or experiencing symptoms of Peripheral Artery Disease (PAD), you may request an appointment with one of our PAD Specialists.