by Bobby Rupani, MD RVT., and Zafar Jamil, MD RVT.

Today in the media, you hear a lot about PAD. Two of HRMCs Board Certified physicians, Dr. Bobby Rupani and Dr. Zafar Jamil, answer some of your questions about PAD below.

What is Peripheral Arterial Disease?
Peripheral Arterial Disease (PAD) occurs when plaque builds up in the blood vessels (arteries) carrying blood to the legs. The plaque consists mostly of fat and cholesterol and is called atherosclerosis. With the build up of plaque, the lumen of the vessel/artery narrows decreasing the amount of blood reaching the legs. The decrease in blood flow to the legs can cause cramping/aching pain in the buttocks, thighs or calves with any activity including walking. PAD can also cause rest pain in the foot, non-healing ulcers/infection of the toes and legs or even gangrene leading to amputations if not diagnosed and treated in a timely manner. PAD is also an indicator of other serious arterial problems like heart attacks and strokes.

What are the risk factors for PAD?
Aging, diabetes, high blood pressure, high cholesterol, smoking, obesity and family history of PAD are some of the risk factors that increase the possibility
of PAD.

How is the diagnosis made?
The diagnosis is made by a Vascular Surgeon based on family history and a physical exam to evaluate blood flow to the legs. This includes non-invasive ultrasound studies and measuring blood pressure in the legs, which takes a few minutes to perform in the office setting and is completely painless.

What are the treatment options?
The treatment of PAD depends on the severity of disease. Claudication or pain in the calf/thigh/buttocks upon walking can initially be treated by lifestyle changes and medications. Lifestyle changes include the following: smoking cessation, weight loss, better control of high blood pressure/diabetes and  holesterol. With worse symptoms, including non-healing ulcers, pain at rest and gangrene, treatment includes minimally invasive techniques or open bypass surgery.

Who do I see for treatment?
A Vascular Surgeon can manage PAD with your primary medical doctor. Vascular Surgeons are specialists that manage all vascular diseases of the arteries,  veins and lymphatics. They can provide you with all of the appropriate options for treating PAD including medical management, minimally invasive procedures and open bypass surgery.

For more information, please call Dr. Rupani or Dr. Jamil at (973) 877-5059.