Category: PAD

6 PAD Symptoms to Know and Watch For

We recently completed PAD Awareness Month, so it’s the perfect time to teach you about identifying PAD symptoms. First, a definition: Peripheral Arterial Disease (PAD) is a disease. It develops when arteries in your lower legs narrow.

Because many PAD symptoms mimic those of other conditions, this disease is often hard to diagnose. About 20 million Americans have this disease. Even worse? Almost 500,000 people end up in the hospital because of PAD each year. (A number that rose sharply between 2011 and 2017, according to a study from Yale University. Especially for men younger men, under the age of 65.)

On its own, that’s a scary statistic. But here’s a fact that should shake you up further. Up to 200,000 Americans with PAD don’t even know they have it! So, in order to prevent a missed diagnosis, we need you to know and identify PAD symptoms. If you experience any of these problems, it’s important to see your Houston vein specialist right away.

Painful Symptoms of PAD

Muscle pain is one of several symptoms of PAD

  1. Pain in Your Legs After Walking or Exercise. One of the most common symptoms of PAD, this pain or cramping occurs with movement because your lower extremities don’t get enough oxygen to support the increased activity.  Most often, PAD sufferers will experience this pain in their calf muscles, but it may manifest anywhere in the lower legs. Pain will typically not resolve until the PAD sufferer stops all physical activity.
  2. Wounds, Sores or Ulcers. This second symptom is also caused by a lack of oxygen reaching your lower limbs. When you cut yourself, and you don’t have PAD, proper circulation and blood flow will help your injury heal quickly. When you have PAD, however, even a small scrape can remain open and unhealed as the plaque in their arteries blocks blood flow to the wound. This symptom must be addressed immediately: left unchecked, a wound can lead to serious infection and even amputation.

    Physical PAD Warning Signs

  3. Skin Changes on Your Legs. Once again, poor circulation is behind this PAD symptom. Some of the physical changes that occur with PAD include skin that appears to be shiny, loss of leg and/or toe hair, and a blue-ish tinge to your skin. Your lower legs, especially your toes, may also feel cold, even when your feet are covered and should otherwise feel toasty.
  4. Muscle, Not Joint, Pain. We’ve already noted that leg pain and cramps are a symptom of PAD, but it’s important to note where that pain is located. Many people think of leg pain as a normal part of aging, and it CAN be–when that pain is happening in your joints. When it’s located in your muscles, however, that is a sign that something beyond normal aches and pains is going on.
  5. Dead tissue. Most people will identify their PAD before reaching this point, but if you have gangrenous or dead tissue on your toes, feet or legs and you haven’t been checked for PAD, get a diagnostic vein scan ASAP.
  6. Changes in bowel habits. In some cases, PAD impacts the arteries that supply blood flow to the intestines, resulting in changes to your bowel movements. The need to empty your bowels could become urgent, and your stool could be bloody. Additional symptoms include severe and diffuse stomach pain, frequent vomiting, a drop in abdominal blood pressure and an elevated white blood cell count. Finally, hydrogen can start building up in your blood, a condition known as acidosis.

    Emotional PAD Symptoms

  7. Depression. Especially for women, your depression symptoms may develop or worsen with PAD. So if you have the symptoms we described above, and depression, it’s time for a PAD check.

PAD Diagnostic Check List for Clinicians

Even when patients come in complaining of these symptoms, some general care physicians may find it difficult to diagnose this condition. Too often, according to this review in The BMJ journal, patients with claudication are told to rest and take aspirin. (Claudication is the medical term for symptom 1 in the list above, or leg pain that manifests with movement and improves with rest.)

As such, they offered a basic guideline for clinicians to use when deciding to refer patients for PAD care. Basically, the study suggests that a PAD diagnosis should be made for patients with claudication or rest pain; who don’t have regular peripheral arterial pulses; and whose tests reveal a reduced ankle brachial pressure index (ABPI). They note that the ABPI score is one of the best PAD indicators, since patients with spinal claudication will have a normal test score, even though their other symptoms may mimic those of peripheral arterial disease.

Can You Prevent PAD Symptoms?

According to the American Heart Association, following life’s “Essential 8” rules can help prevent cardiovascular diseases, including PAD. (In 2022, this list was updated from the Simple 7, adding sleep as an essential lifestyle choice to prevent cardiovascular disease.)

What are these crucial eight steps you can take to prevent periphery arterial disease and other forms of heart disease?

  1. Follow a healthy diet
  2. Move more, every day
  3. Get sufficient, quality sleep each night
  4. Manage weight
  5. Control your cholesterol levels
  6. Watch your blood sugar levels, too
  7. Control your blood pressure
  8. Break up with tobacco

Preventing and Treating PAD in Houston, TX

We urge you to watch for PAD symptoms. But it’s also important to know your risk for this disease, since you may not develop symptoms until your disease has progressed dramatically. After all, if there’s one thing we need you to remember, it’s this: PAD is a progressive disease. If you ignore early warning signs, your symptoms of PAD will get worse. Don’t wait until you’re in pain. Call our Houston and Dallas area clinics today and schedule an immediate PAD consultation!

 

Sources: Mayoclinic.org , Healio Cardiology 

PAD Risk Factors for Women and African Americans

Today, we need to talk about PAD risk factors for women. And for African Americans. Because both groups may be more vulnerable. In fact, according to a J&J campaign to raise PAD awareness, millions of Black Americans don’t even know they have this disease. (You’ll hear more about this campaign in a minute. But first, let’s talk PAD.)

Remember, PAD (peripheral arterial disease) is a thickening of the arteries that affects blood flow. It’s a form of cardiovascular disease with symptoms such as painful leg cramps. And those cramps mostly show up when walking or exercising, but get better with risk.

Now, we don’t know why, but women and African Americans are nearly twice as likely to be affected by PAD. That’s the case even for women and Black people without other heart issues. Regardless of age. Now, while this statistic is scary on its own, we also have to share warnings about things that further increase the PAD risk for women and African Americans.

PAD Risk Factors for Women Smoking: one of many PAD risk factors

Not every woman has the same PAD risk factors. Therefore, you have to look at other factors to figure out your own risk for PAD. Women who are over 60, or who have high blood pressure or cholesterol, have higher PAD risk. But, studies show that PAD risks for women without these factors are almost double that for men without heart disease.

And that’s not all. In a study in the Journal of the American Heart Association, we learned other concerns about the PAD risk for women. As it turns out, women get diagnosed with PAD later than men. Then, after their PAD diagnosis, women’s health deteriorates faster than men’s. In particular, women with PAD lose their ability to walk at a faster rate than men do. Which is why women should start early screening for PAD to help prevent these concerns. As should African Americans, who have additional worries when it comes to their PAD risk.

BMI and PAD

Regardless of your race or gender, your body mass index has an impact on your PAD risk. In a recent study, researchers found a u-shaped relationship between BMI and PAD risk. They discovered that people with BMIs below 25.7 saw a 27% decrease in risk for Peripheral Arterial Disease. And, while there wasn’t a concrete number, people with a BMI level above 25.7 had a significant disease risk increase. Want to know your BMI and relative PAD risk? Start with this resource from the National Institutes of Health.

Smoking and PAD Risks

According to a different study in the Journal of the American Heart Association, smoking is a known risk factor for PAD. But it increases PAD risk for African Americans more than for other at risk groups. In this study, researchers followed 5300 participants between the ages of 21 and 84. Of those participants, 13% were current smokers and 19% were former smokers.

Researchers found that current smokers were twice as likely as non-smokers to have PAD in their lower extremities. They were also eight times as likely to have calcium buildups in the aorta. And how much you smoked matters too: the more cigarettes a participant had smoked each day, the worse off their arterial health.

In the wake of this study, Mariell Jessup, chief science and medical officer of the American Heart Association, says: “The findings from this study give us strong evidence of the specific debilitating and life-threatening risks African American smokers face, especially the more they smoke. This type of research can be useful in the development of clear messages targeted to our African American population to underscore the real physical costs of tobacco product use.”

Additional PAD Risks for Black Patients

Recently, an Annals of Surgery study gave patients of color even more reason to be concerned about PAD. After following 7,000 patients with peripheral arterial disease who’d had a lower leg bypass to boost circulation, a team of researchers at Michigan Medicine concluded that African American and low income indivduals experienced the worst outcomes.

Specifically, these patients had much higher rates of chronic limb-threatening ischemia (CLTI), a severe disease form that often leads to amputations. In fact, one year after surgery, Black study participants were much more likely to have an amputation than other patients. And that was true, regardless of disease severity. As a result, lead study author Dr. Chloe Powell says, “Health care providers need to recognize the vulnerability of certain subgroups to adverse outcomes and be on alert for early signs and symptoms of PAD, to manage patients accordingly.”

Reducing PAD Risk Factors

Even if your PAD risk is high, you can take steps to prevent disease. In a new study in the European Journal of Vascular & Endovascular Surgery, researchers found that making four healthy lifestyle choices helped prevent peripheral arterial disease.

What were these four choices?

  1. Avoiding too much alcohol.
  2. Following a healthy diet.
  3. Staying moderately to highly active.
  4. Never smoking. (But you probably guessed that one already.)

In fact, these measures were so effective that they reduced your risk by 12%, 16%, 26% and 54% respectively. So imagine what an impact they could have if you worked with all four in combination!

Efforts Toward Equity

In further attempts to improve health equity outcomes, Johnson & Johnson has launched a multi-year, $100 million campaign titled “Our Race to Health Equity.” Launched at this year’s American College of Cardiology conference, their first initiative is titled, “Save Legs. Change Lives. Spot Peripheral Artery Disease Now.”

As the initiative gets going, J&J will send an “empower PAD” mobile health unit into communities where PAD rates are high. Their goal is to test between 50 and 60 people at each of their 90 screening events. And they will make special efforts to reach Black Americans, since they are more likely to have PAD without displaying any symptoms.

The key in this initiative, and in our Houston and Dallas area offices, is to get an early diagnosis before you develop devastating complications. So, if you’re worried about your risk for PAD, we’re here to help. If you are in a vulnerable population, or have any type of heart disease, preventative screening is important. Schedule an appointment with our Houston vein specialists right away. We can help determine your PAD risk level, and start you on preventative care or treatments.

Sources: Journal of the American Heart Association

Here’s How Our Endovascular Procedures Help Chronic Limb Ischemia Treatment

When you have Type 2 diabetes, you’re at a higher risk for peripheral arterial disease (PAD) as well as critical limb ischemia (CLI). With CLI, there’s also a risk of tissue loss from ulcers and gangrene. And, for that reason, you’re more likely to need chronic limb-threatening ischemia treatment (CLTI).

Recently, a study came out explaining how endovascular treatments can help with CLTI outcomes. Of course, our Houston and Dallas area interventional radiologists are excited about these findings. So, today, we’ll review how endovascular therapy can improve ischemia treatment outcomes. But first, let’s take a closer look at the complex conditions we’re exploring in this post: PAD, CLI and CLTI.

What is PAD? endovascular therapy boosts ischemia treatment

Peripheral Artery Disease (PAD) describes a build-up of plaque in your arteries. With this condition, you’ll experience slower blood flow from the heart to the rest of your body. But what’s that plaque composed of? Well, it forms from cholesterol, calcium, fibrin, and fatty substances. Over time, that mix narrows or ‘hardens’ your arteries. (We call this Atherosclerosis.) And, once atherosclerosis sets in, reduced blood flow to your vital organs and limbs will make it harder for them to keep up with your body’s demands. Soon, you’ll notice painful symptoms such as leg cramps with movement. You may also develop changes in skin color, patches of hair loss on your legs, ulcers and other warning signs and symptoms.

What is CLI?

This is a severe form of PAD. When you have CLI, you often experience chronic pain, even without movement. Your risk for ulcers and gangrene are also much higher. And that’s because of the long-term lack of sufficient blood flow to your lower limbs.

With CLI, you may also experience unpleasant symptoms such as foot pain and/or numbness, and a reduced or missing pulse in your feet. Additionally, leg and foot wounds will take longer to heal, which is why you’re at greater risk for ulcers and tissue death.

What is CLTI? swollen, painful legs and ankles could be lymphedemaolding knee

This is a clinical diagnosis we’d make if you have PAD as well as resting foot pain and a lower leg ulcer or a gangrenous patch for 2 weeks or longer. We consider this diagnosis to be extremely dangerous; with CLTI, you’re at a very high risk for limb loss.

Furthermore, research reveals that chronic limb-threatening ischemia increases social isolation, especially for younger patients, which was surprising since older adults are usually more susceptible to loneliness. Clearly, CLTI takes a physical and emotional toll on your body. So you need to seek ischemia treatment. And, according to new study findings, seeking endovascular care to open up your arteries could be a great option.

How Endovascular Therapy Boosts Ischemia Treatment

Clearly, seeking ischemia treatment can prevent limb loss. And that’s especially true for people with diabetes, who have additional circulation challenges, even without PAD. Until recently, ischemia treatment options included wound treatment, controlling the infections, and arterial revascularization. In many cases, amputation was unavoidable.

Now, there are two ways to pull off arterial revascularization. These include bypass surgery or endovascular interventions. As interventional radiologists, we always prefer the endovascular approach. We believe that it minimizes the risks of undergoing open surgery. Plus, it does so while yielding similar or greater results.

But you don’t have to take our word for it! In fact, in a recent review of two patients with CLTI, researchers followed two diabetic patients with unhealed lesions. Both patients received quality wound care, help for their glucose levels, and endovascular therapy to restore blood flow. Here’s what the study revealed about this approach to ischemia treatment.

Endovascular Arterial Care to Speed Ischemia Treatment

The two patients involved in this study received endovascular therapy to restore arterial blood flow. For the first patient, that meant an angioplasty. With this approach, therapists use a balloon to widen a diseased artery. And that way, more blood flows through.

Now, the second patient’s therapy involved stent placement in the diseased artery. That means doctors placed a tiny, expandable coil in the troubled artery. This coil can push aside built up plaque and help boost blood flow to the lower limbs.

While both endovascular patients received different forms of therapy, they enjoyed similar results. Their wounds healed, and their painful symptoms resolved. As such, researchers concluded that seeking ischemia treatment with an endovascular procedure “may result in a better outcome of wound healing.”

Emerging Options

For some patients with CLTI, revascularization is no longer an option. And these are the very patients at most risk for an above-ankle amputation. Luckily, emerging results from the Promise II clinical trial reveal a new procedure that may offer hope for limb protection.

In this ongoing study, patients received transcatheter arterialization for their deep veins (TADV). This was accomplished with a minimally invasive procedure using the LimFlow System. Basically, this procedure gets blood flow around  the permanently blocked leg arteries by ‘turning off’ valves in the lower leg vein. In this way, the veins are now able to carry blood down to the foot, giving it the oxygen necessary to avoid amputation.

Though the research is still in a trial phase, early results are promising. Six months after receiving TADV, 76% of the patients in the study were able to keep their limbs. As such, we will be carefully watching ongoing research into this procedure. But, in the meantime, we encourage earlier interventions, so that arterial revascularization is still a viable treatment option.

Arterial Revascularization for Ischemia Treatment in Houston, TX

Are you living with PAD and worried about CLI and limb loss? Our Houston and Dallas area vein specialists are here to help. In our Houston, Katy, Sugar Land, Clear Lake and The Woodlands locations, we offer arterial angioplasty, stenting and atherectomy therapies. So, if you’ve been told that ischemia treatment is the best way to save your limbs? Don’t rush to the surgical table. Instead, schedule a consultation with our doctors. We’ll help you explore less invasive ways to manage PAD and prevent amputations!

Sources:

Vascular Health Risk Management, Cureus

 

 

Move it Monday: Best Exercise for Peripheral Arterial Disease

Did you know you can boost your health with the best exercise for peripheral arterial disease? When you have peripheral arterial disease (PAD), your arteries narrow. First, that reduces the amount of blood flow to your legs and feet. Then, you may experience painful muscle cramps in your hips, thighs and calves. This pain is typically at its worst when you’re walking, climbing stairs or exercising. And it should improve when you rest. At least at first.

Now, while exercising may make you experience painful cramps, research shows that certain exercises will, in fact, help you manage PAD.person walking through grass

According to one study in the Intervention Journal, supervised treadmill workouts are the most effective form of exercise for people with PAD. Study authors suggest: “exercise sessions should progress up to a target goal of accumulating 30 to 45 minutes of treadmill walking per session” and “exercise should be carried out at an intensity that elicits mild claudication pain within 5 minutes, and moderate to moderately severe claudication within 10 minutes followed by rest until claudication pain subsides.” In other words, the goal of this workout is to work to the point of pain until the pain takes longer to show up. In this way, PAD patients can experience longer periods of walking comfort in their real lives as well.

Optimal Walking Times

When you’re beginning a walking program, you may wonder how much time is enough? Luckily, according to the World Health Organization, it doesn’t have to be that long. In fact, 150 minutes of walking a week gives you so many health benefits!

What does that mean for you, if you’re doing supervised treadmill sessions for PAD? To hit your weekly walking goal, you could do three 45-minute sessions, and one 30 minute session. That way, you’d get all the benefits of walking workouts. And, you’d see progress with PAD symptoms such as claudication.

Not able to hit that 150 minute per week mark? Or struggling to hit 10,000 steps? Don’t worry. Any walking you can fit into your day will improve your health. Of course, it doesn’t have to be on a treadmill either. It can be scattered throughout your day. Or a part of these alternative workouts for PAD.

Alternatives to Treadmill Workouts for PAD

Of course, for some PAD patients, treadmill walking may be too difficult–or simply unappealing. Not to worry: the study suggests other forms of exercise that can also be effective. The authors suggested walking around your neighborhood as one obvious alternative to treadmill workouts. Seated exercise bikes can also help people with PAD, as can workouts that involve resistance training, with your body weight, bands or weighted dumbbells.

While exercise can help improve your ability to walk comfortably with PAD, it cannot cure the condition. Fortunately, in our Houston vein center, we can easily diagnose and treat your PAD. We star with a bedside test, called an Ankle-Brachial Index (ABI), which uses ultrasound and blood pressure cuffs to evaluate the circulation in your arms and legs. If this test is abnormal we may order further imaging tests such as Magnetic Resonance Angiography (MRA) or Computed Tomography (CT) to determine the extent of your problem and help us plan your treatment.

Once we determine the extent of your issue, treatment can begin. Our doctors will determine the most appropriate, and least invasive, treatment option that will help you find relief. So if you are experience leg cramps and suspect PAD may have set in, schedule an immediate consult to begin finding relief!

Sources: www.interventionjournal.com, Cardiology Today

 

Best Exercise for Peripheral Artery Disease

Exercise and PAD are an important combination if you want to avoid pain when you move. You see, if you have Peripheral Arterial Disease (PAD) you may experience painful leg cramps. That’s because, with PAD, your atherosclerosis (hardened or narrowed arteries) limits blood flow to your legs. And this lack of blood flow leads to leg pain, especially when you walk or exercise.

Surprisingly, even though it hurts to move, increasing your movement can help manage and reduce your PAD pain. That’s why physical activity is so important for anyone living with this condition.

Exercise and PAD

Even though our country is starting to emerge from the coronavirus outbreak, you might have gotten out of your gym routine and started home workouts. That makes a lot of sense, especially if you have compromised health because of underlying conditions like PAD. But, it doesn’t mean you have to give up on your exercise routine. It just needs to change a little.

In fact, there’s great reasons to keep exercising, even in these scary times. Research suggests that getting mild to moderate exercise, every day, can boost your immune system and help control your PAD symptoms. Just remember, for both this outbreak and your PAD, “moderate” is the key. Anything too intense could leave you hurting, and reduce your immune response.

Smart Exercises for PAD

Since walking is one of the best workout options for people with PAD, why not simply take your workouts outside? Pick a quiet outdoor spot and stroll away. Bonus: exercising outdoors gets you in nature, which can help calm anxiety—something many of us are grappling with right now.

Go for as long as you can, even working up to a slow jog if you’ve discussed this with your vein specialist. Just keep your distance from any other outdoor workout warriors—six feet is the recommended length. This way, we can work together to prevent the spread of disease, without sacrificing your personal fitness.

Treating PAD to Make Exercise Easier

When you have PAD, walking can trigger pain. (We call this claudication.) But exercise improves PAD symptoms over time. In fact, new research in JAHA shows that walking fast enough to cause this pain is actually important. Because, after six and 12 months, study participants who kept up a walking pace that caused leg pain or discomfort walked noticeably longer distances per minute than study participants who walked at a comfortable pace. (Or who skipped walking workouts altogether.)

In contrast, research from the National Institute of Aging suggests that taking the blood pressure medication telmisartan doesn’t improve walking performance for patients with PAD. (Though it can reduce your risk for heart attack and stroke.) Still, that doesn’t mean other treatment options won’t help you walk better with PAD. Because, over time, treating your PAD in other ways can actually make it less painful to exercise. In fact, new studies show that treating PAD with angioplasty gets more oxygen to your legs.  After treatment, researchers found that patients experienced less leg fatigue and breathlessness. (Even when they exercised at the peak of their efforts!)

What does that mean for you? If you’re living with PAD, keeping active can help you stay healthy. But you may need more help–and PAD treatment–in order to exercise without pain. Ready to get more active? Reach out to our Houston and Dallas area arterial specialists for an appointment today. We are happy to offer a PAD assessment, and help you find the relief that you’re seeking!

Sources: Physiology Report

When Should I Treat PAD?

Are you wondering, when should I treat PAD? This read is for you because, if you’re showing signs of Peripheral Arterial Disease (PAD), you may be scared. Chances are you’re experiencing symptoms such as leg cramps when you walk, changes in skin color, cold or numb feet, or even ulcers. Obviously, you want relief from the discomfort. But we understand that you may live quite some distance from our Houston and Dallas area offices. (That’s why we still offer Telemedicine appointments for many vein conditions.) PAD magnified

Still, you need to understand that PAD poses a very serious risk to your health. In fact, studies show that having PAD is one of the strongest predictors for cardiovascular diseases like heart attacks and strokes. In other words, it’s not something you ignore, or even delay addressing. Want to learn more? Just keep reading!

When Should I Treat PAD? When Symptoms Develop

It’s important to seek PAD treatment as soon as you notice symptoms. The most common symptom of PAD is leg cramps. They tend to appear when you’re walking or exercising, and improve when you rest.

But other symptoms could mean you have PAD. Another common PAD sign is having cold feet. Now, in some cases, cold feet and hands just mean your blood flow is compromised. Other times, cold feet are a sign that narrowed arteries are restricting blood flow to your extremities. If that’s the case, you need immediate PAD treatment. Otherwise, your risk for cardiovascular disease will increase dramatically.

What is Cardiovascular Disease?

Cardiovascular disease impacts your heart and blood vessels. It takes many forms, including atherosclerosis (narrowing of your arteries due to the build-up of ‘plaque.’) But, basically, it encompasses four main conditions: strokes, aortic disease, coronary heart disease, and peripheral arterial disease. Cardiovascular disease is very serious. It is still the leading cause of death in the United States—meaning it’s still more life-threatening than the Coronavirus.

Given the serious nature of heart-related conditions, you must stay on top of problems like PAD, even now. Because, according to our study, doing so could mean the difference between progressive heart disease or improved health.

In this new study from Penn State University, researchers explored the connection between your heart health and your blood pressure, diet, and physical activity levels. To reach its findings, the study followed over 74,000 participants for a few years, watching their lifestyle patterns and their cardiovascular health. Here’s what they found.

How Can I Prevent Heart Disease?

angioplasty for PAD

In order to really reduce your risk for cardiovascular problems, participants needed to follow the American Heart Association’s 7 measures for good heart health. They involving maintaining healthy cholesterol, blood sugar, and blood pressure levels. You must also exercise regularly, maintain a healthy weight, follow a healthy diet and avoid or quit smoking.

Interestingly, the study discovered that each of these seven measures is equally important. Doing just one is obviously better than nothing; but they have the highest heart-protecting power when they work together.

In other words, if you’re still deciding when to treat your PAD, the answer is: right now. Because even minimally-invasive PAD treatment offers lasting relief.

Restored Blood Flow Translates to Pain Relief

Findings presented at the American Heart Association’s Scientific Sessions 2022 reveals that restoring blood flow with an arterial stent or balloon angioplasty reduces pain and improves quality of life for patients with PAD. (We offer both these endovascular treatments in our Houston, Katy, Sugar Land, Clear Lake and the Woodlands locations.)

In contrast, a recent statement from the American Heart Association says that the quality of life toll that PAD takes on your daily life “cannot be overstated.” And the impact isn’t just one you’ll feel in the short-term. Why is that the case?

Once atherosclerosis limits blood flow to your legs, that’s already a sign you’ve got cardiovascular problems. And that means your car’s on the road to more serious complications. So, before you get stuck in the traffic jam leading to strokes or heart attacks, take a detour to better health.

Need help finding that off-ramp? Request an appointment with our Houston and Dallas area PAD specialists today. We are here to offer timely PAD treatment.

Sources:

Journal of Cardiology, “Association of Trajectory of Cardiovascular Health Score and Incident Cardiovascular Disease.”

 

 

Here’s What you Need to Know about Bloodclots

In our Houston vein practice, we know how serious a threat bloodclots pose to your health. When we treat patients with Deep Vein Thrombosis (DVT), a condition in which blood clots form in the deep veins of your legs, we face a medical emergency. That’s because, if a blood clot breaks free and travels to other parts of your body—especially to your lungs—it can threaten your life.

But, many people want to know: why do I get blood clots? And, what are they exactly? Is there anything I can do to prevent them? So, in this post, we will try to answer all of those questions. Just keep reading to learn more.

Why do bloodclots form? stages of PAD

When things are working properly, your blood flows freely through your body, delivering oxygen to your organs and flushing out the waste products created by your body’s metabolic processes. But, if you get a cut, scrape or injury, blood in your arteries and veins (veins return blood from the body to the heart; arteries transport blood away from your heart) will clot to block your blood vessels and stop you from bleeding out.

But, when your arteries or veins get blocked when you aren’t injured, you need medical intervention. Otherwise, you can face complications such as strokes, heart attacks, organ damage and even limb loss. On certain occasions, as we mentioned earlier, blood clots can kill you by traveling to your lungs (pulmonary embolism), interfering with your ability to breathe.

Blood clots form in blood vessels—either your deep veins or your arteries. Typically, they form after your blood vessels get damaged, triggering a reaction in your body. This reaction involves a mix of platelets and clotting factor proteins.

Bloodclots Risk Factors

Anyone can develop a clot. But certain issues raise your risk. About 8% of the population experiences hypercoagulation, a condition that makes your blood clot more often. But for those of us who don’t face this concern, pregnancy, heart disease and cancer could all increase your risk.

Still, even your lifestyle could be an issue. Being stuck in bed for extended periods makes bloodclots more likely to form. Any damage to your blood vessel walls, either due to injury or surgery, could also spell trouble. Finally, while research is ongoing, prior COVID infection seems to trigger an inflammatory response that could make your blood more likely to clot.

Warning Signs and Symptoms

Since a blood clot in your legs can break free and travel to your lungs, it’s very important to recognize the early warning signs. With a clot, you may notice a hard lump in your leg, which could also display inflammation. When the affected vein is near your surface.

When your surface veins are impacted, some people describe clots as feeling like thin sausages. And, in many cases, the skin on top of that bulge appears red in color. If you notice any of these signs, seek immediate medical attention. Otherwise, you’re at risk for serious medical complications and health concerns.

How Do Blood Clots Cause Health Problems?

As we mentioned, problematic blood clots form when the connection between platelets and clotting factor proteins goes awry. Platelets are objects in your blood that group together and stick to the walls of your blood vessels when needed.

Clotting factors are proteins in the blood that trigger a reaction to makes platelets and red blood cells stick together. Typically, other proteins in your body make that reaction stop, so your clot only reaches the size needed to prevent excess bleeding.  But when damage to your blood vessels impacts that reaction, clots may grow unchecked, leaving you at risk for clotting conditions like DVT.

Arterial clots and DVT

We can’t always predict who will be affected by blood clots, or when those clots will form. But we do know certain factors that can increase your risk for clots:

  • Prolonged immobility, as with long airplane flights
  • Having thick blood (hypercoagulability.) Often, you only discover your blood is thick after developing a clood clot. But in some cases, hypercoagulability causes chest pain, dizziness, slurred speech and shortness of breath. Usually, this condition is a symptom of other diseases, including vascular diseases suches as polycythemia.
  •  Arm or leg surgery
  • Casting a broken bone
  • Trauma
  • Smoking
  • Being pregnant
  • Diabetes
  • Obesity
  • High blood pressure
  • High cholesterol
  • Age
  • A family history of peripheral artery disease (PAD), stroke or heart disease.

Remember, PAD develops when you have atherosclerosis. Atherosclerosis, a type of arteriosclerosis, is a condition where plaque builds up in your arteries. It specifically means that plaque built up on the inner most wall of your artery. Once that happens, your arteries narrow and ‘harden.’ In turn, this reduces blood flow to certain parts of your body. And it also increases your risk of blood getting ‘stuck,’ and forming clots.

New research has revealed an additional risk factor for blood clots, and it’s one that you unfortunately can’t control. In fact, your blood type can contribute to that risk, according to a study published in the Journal Arteriosclerosis, Thrombosis, and Vascular Biology. 

The research, which began in 2017, found that people with types A or B blood had a combined 8% higher risk of heart attack, and a 10% increased risk of heart failure, as compared to people with type O blood. So, knowing your blood type could help you understand your risk for developing a blood clot.

 

Diagnosing and Treating Blood Clots

The best way to treat blood clots is to prevent their formation. Some evidence suggests that drinking one glass of wine or red grape juice daily could help prevent bloodclots. Why is that the case? Well, red grapes contain an antioxidant called polyphenol that prevents the platelets in your blood from sticking together to form a clot.

But grabbing a glass of vino can’t be the only preventative measures that you take. Maintaining a healthy lifestyle, staying mobile even on long trips, and using compression therapy can all help protect you from DVT. Even if you develop a DVT, compression therapy—especially within 24 hours of the clot’s formation—can help manage your risk of further complications.

So, as with many other vein and arterial conditions, timeliness is key when it comes to treating blood clots. The sooner you see a vein specialist, the better the outcome you will likely enjoy. So if you have any symptoms of or risks for blood clots, schedule an appointment with your Houston vein specialists today!

 

Sources: Arteriosclerosis, Thrombosis and Vascular Biology JournalAmerican Heart Association

 

Signs of PAD Men and Women Need to Know

We want to tell you about the signs of PAD men and women need to know. Because we want to raise awareness for heart disease. And PAD is just that.

Remember: peripheral Arterial Disease (PAD) occurs when plaque in your arteries slows the flow of blood from your heart to the rest of your body. That ‘plaque’ is mostly composed of cholesterol, calcium, fibrin, and fatty substances. As it collects in your arteries, they narrow and harden (Atherosclerosis). And, as the rest of your body gets limited blood flow, they aren’t able to function optimally.  Some people with PAD will experience symptoms right away. Others won’t know they have a problem in the early stages of this disease. And, even when PAD does cause symptoms, it can be difficult to diagnose, since these symptoms often mimic those of other conditions. Of course, there’s one more issue that can make it difficult to treat diagnose PAD: the disease may look different in men than in women. Let’s take a closer look.

What are the Symptoms of PAD?

As we mentioned, you could have PAD and not experience any symptoms. Still, all of the following are considered PAD symptoms. If you experience one or more of these issues, you should talk to your vein specialists right away. Symptoms of PAD include coldness or numbness of the legs and feet, discoloration in the legs, cramping of the hips, thighs, or calf muscles and difficulty in healing from minor wounds of the legs or feet.

You may also notice burning or aching sensations of the feet, poor toenail growth, pain while or soon after walking, slowed hair growth on the legs. In men, you may even see erectile dysfunction,

Now that we’ve reviewed PAD presentations for both genders, let’s explore some of the different ways the disease manifests by gender.

What Does PAD Look Like for Men vs. Women?

Men seem to develop PAD symptoms earlier than women, although that is not always the case. As a result, male PAD patients may see their doctors sooner, allowing for earlier interventions and improved treatment outcomes.

Because women with PAD tend to get later diagnoses, they also appear to develop more simultaneous chronic conditions (comorbidities). Also, according to new research, body fat and menopause can increase women’s PAD risk. Specifically, upper body fat seems to increase your post-menopause PAD risk. But lower body fat appears to have the opposite effect.

Additionally, post-menopausal women tend to develop calcium buildup in their breasts. The same is true of women with type II diabetes, high blood pressure and/or inflammation. That makes sense in many ways. Because, according to this study, that build-up increases women’s cardiovascular disease risk by 51%. This risk was for any kind of heart disease. But, their specific risk for peripheral arterial disease rose by 23%. As a result, we now view breast calcification as a marker for arterial disease. And women with one condition should be monitored for the other.

Even worse? Another new study reveals that osteoporosis increases your PAD risk by as much as 28%. And, because women start off life with lower bone density, and lose bone mass faster, they develop osteoporosis more often.

Even so, and regardless of body fat distribution, in patients with PAD and diabetes, male patients are more likely to face limb loss due to amputation.

Why is PAD so Dangerous?

Since your arteries are narrowed by PAD, and your blood isn’t flowing as it should, a blood clot can form on the surface of your plaque build-up, creating a potentially life-threatening situation if that clot travels to your lungs. It’s also possible for a piece of plaque to break off and completely cut off your blood flow, resulting in a heart attack or stroke.

But wait, there’s still more: because PAD affects blood flow to your limbs, if PAD goes untreated long enough, you may develop gangrene in one or more of your limbs (gangrene is the term for the death of body tissue due to lack of blood flow or serious infection.)[i] And if you develop gangrene, you will face partial or full limb amputation. Clearly, treating PAD is crucial to your long-term health.

How Can I Treat PAD?

We can easily diagnose PAD in our office, using a bedside test called an Ankle-Brachial Index (ABI). During this procedure, we use ultrasound and blood pressure cuffs to evaluate the circulation in your arms and legs. If your results aren’t what we want to see, we may order further imaging tests such as Magnetic Resonance Angiography (MRA) or Computed Tomography (CT) to determine the extent of your problem and to help us plan your treatment.

At Texas Endovascular Associates, we are passionate about treating patients who suffer from PAD. We use the most up-to-date, state-of-the-art equipment available to treat your disease. Recently, we learned of a new American Heart Association Scientific Statement published in the journal Circulation. It suggests that patients’ symptom experiences should guide treatment decisions.

Specifically, they suggest: “The person living with peripheral artery disease is the authority on the impact it has on their daily life. Our treatment must be grounded in their lived experiences and go beyond the clinical measures of how well blood flows through the arteries,. ”

To that end, we urge you to come in when your symptoms are mild to moderate. Because, in the early stages of disease, you can try to boost circulation to your feet. Moving more is a great way to boost blood flow to your feet. That’s why we share weekly exercise tips to help your circulation and vein health.

You can also change your diet to improve vein health and circulation. Be sure to avoid circulation-busting culprits like alcohol, caffeine and nicotine. (Or any other items your specialist says to steer clear of.) You could also score some pairs of compression socks, possibly even prescription ones. These now-stylish wardrobe staples really improve blood flow to your feet.

Specialized Care for PAD in Men and Women

Sometimes, though, these at-home efforts won’t be enough. And that’s when our vein specialists will discuss other treatment options. But don’t be scared.

Using minimally invasive procedures that do not require an overnight hospital stay, our team provides treatments such as Angioplasty, Stenting, and Atherectomy. In that way, we’re often able to spare you from more invasive, open surgeries. In fact, many of our PAD patients get discharged the same day as their procedure, facing minimal recovery time once they get home!

If you’re experiencing PAD symptoms, don’t wait for a consultation. We can even begin your treatment process via Telemedicine, although you will have to come to the office for a final diagnosis. And, if you’ve already been diagnosed with PAD, it is important that you not delay treatment. Doing so can allow your disease to progress, raising your risk of fatal complications.

 

Sources: Mayoclinic.org, MDmag.com

[i] Mayoclinic.org. “Gangrene.”

6 Ways Leg Pain PAD Shows Up

Worried about leg pain PAD? You’re not alone! Peripheral Arterial Disease is a tricky condition. Its symptoms look like many other vein health problems. Meaning you often wait to get your diagnosis. Take a classic symptom like tired, heavy legs, for example. At some point, everyone’s legs get tired. If you’ve walked a lot during the day, had a hard work out, or just been stuck on your feet, you may get muscle cramps or leg fatigue. And that would be perfectly normal. Sometimes, however, that discomfort in your legs could be something more serious: peripheral arterial disease, a condition in which plaque narrows your arteries, limiting blood flow to your lower extremities. Here’s how you can tell when your leg pain is a cause for concern. And a roundup of other warning signs and symptoms that could indicate trouble with your blood flow.

6 PAD Warning Signs to Watch For

PAD-affected arteries before, during and after minimally invasive treatments
  1. The leg pain PAD causes is constant. Normal leg pain only comes on once in a while. But if your legs hurt or you feel a burning sensation in your legs or rear end every time you walk or climb the stairs, it could be PAD. This is especially true if your discomfort shows up with movement and resolves with rest. That’s a likely sign of a problem, since your limited blood flow makes it painful to move, because that movement needs oxygenated blood, and your body can’t supply it.
  2. You have heavy legs. Now, this could also be a symptom of varicose veins. But leg pain PAD causes also leads to cramping and some of the other signs listed below. So heavy legs in combination with any of these other warning signs should send you for a PAD checkup.
  3. Your wounds don’t heal. Because PAD limits blood flow to your lower legs, it reduces the healing time for any cuts or injuries. So even a little scratch could become a major health challenge, since oxygen-rich blood doesn’t arrive to help with healing. If you have leg pain and an ulcer, that’s a likely sign that you’ve got PAD.
  4. Your hair growth changes. When blockages limit blood flow to your legs, that alters the way your hair cells function in the area. And that means your leg hair growth will slow or stop. Or you may even notice hairless patches on your legs.
  5. Your legs and feet are cold. Now, this symptom could be a sign of poor circulation. But if the problem is chronic, instead of problem that arises from time to time, it could be a sign of PAD.
  6. Your lifestyle puts you at risk. Smokers, people with diabetes, or individuals with high blood pressure and high cholesterol are at higher risk of developing PAD. (Remember, cholesterol is a fatty substance your liver produces. You need some cholesterol for your body to function. But choose the ‘bad’ kind, or allow cholesterol levels to rise too high, and it can form blood-flow blocking ‘plaque’ in your arteries.) If you have these risk factors and experience regular leg pain, be sure to get checked for PAD. At our Houston-area vein clinics, we can help you get an accurate diagnosis so we can begin the healing process.

Treating Peripheral Arterial Disease in Houston

The above symptoms aren’t all you need to watch out for. Other signs of PAD include cold, numb legs and feet; changes in your skin color; poor toenail growth; changes in your leg-hair growth; and even erectile dysfunction in men.

We can diagnose PAD in our office with a bedside test called an Ankle-Brachial Index (ABI), which uses ultrasound and blood pressure cuffs to evaluate the circulation in your arms and legs. If this test is abnormal we may order further imaging tests such as Magnetic Resonance Angiography (MRA) or Computed Tomography (CT) to determine the extent of your problem and help us plan your treatment.

PAD is a serious medical condition, but help is readily available, often without surgery. Using minimally invasive procedures, our Houston and Dallas area vein specialists can help open up your arteries and restore blood flow to your lower extremities. But before we can help, you need an accurate diagnosis, so watch for warning signs and see your doctor right away if you have any cause for concern.

 

Sources: American College of Surgeons, galesburg.com

These are your Peripheral Artery Disease Risk Factors as you Age

So many things affect your peripheral artery disease risk factors. Now, did you know that approximately one in five people over the age of 65 has peripheral arterial disease (PAD)? And that about 236 million people currently suffer from this condition, with cases on the rise? If that seems like a big risk to most older adults, there’s a reason: it is! And that’s because, as you get older, your risk for PAD increases dramatically. Here’s why.

What is PAD?

PAD is a condition you develop when plaque builds up in your arteries. What is plaque? It’s a substance in your blood that’s made up of fat, cholesterol and other substances. When it sticks to the walls of your arteries, they ‘harden’—that’s called atherosclerosis, and atherosclerosis interferes with your blood’s ability to flow.

When it’s the blood flow to your legs that’s impacted by plaque, we call that condition PAD. And PAD can lead to leg pain and numbness. The hair on your legs may fall out; your skin color may change. You may find that cuts and scrapes take longer to heal; some wounds will no longer heal on their own when you have PAD.

But PAD symptoms aren’t just experienced in your legs. When you have PAD, your risk of heart attack, blood clots and stroke also increases. So does your chances of losing a limb to amputation.

Why Does PAD Develop? stages of PAD

While the exact cause of this condition isn’t known, it seems to begin when the inner layers of your arteries get damaged: this damage could be the result of a diet that’s high in fat and cholesterol; a lifestyle that includes smoking; diabetes; and/or high blood pressure. It seems that plaque builds up as your arteries begin to heal.

Women and certain ethnicities also have higher risks for PAD. (Though we aren’t sure exactly why.) And we know that too many people with asymptomatic PAD are at high risk for complications. Why is that the case?

Unfortunately, PAD can be hard to diagnose. That’s because many people with this condition don’t show any symptoms. Or, they experience symptoms like leg pain, numbness, and cramping, but confuse these problems for normal signs of aging, or for signs of other medical problems. That’s why it’s important to know all the PAD symptoms, which include: sores that don’t heal well, bluish skin color, skin that’s cold to the touch; problems with toenail growth; and, in men, erectile dysfunction.

Other Increases in Peripheral Artery Disease Risk Factors

A study from the International Journal of Environmental Research and Public Health now shows that migraines are a PAD risk factor. While they aren’t sure why, it seems that migraine sufferers and PAD patients both have vascular abnormalities. For that reason, suffering from regular migraines could be considered an early PAD symptom. And, since PAD is often silent until damage is extensive, it’s worth scheduling a diagnostic ultrasound if migraines are a regular problem from you.

Interestingly, the study found additional PAD risk factors. It noted that age, smoking, diabetes and hypertension all increase your risk for PAD. But it also added chronic kidney disease and asthma to the list of conditions that increase your PAD risk. Which means that, if you have any of these conditions, it’s worth checking in with a PAD specialist.

That’s also true if your BMI is on the higher side of optimal. Why is that the case? A study in the International Journal of General Medicine recently discovered that having a BMI below 25 decreased your PAD risk by 27%. Unfortunately, the opposite is true for those with a BMI that’s higher than 25. In those cases, PAD risk was substantially higher. Meaning you should regularly check your arterial flow if your Body Mass Index is elevated. (Check yours here!)

Finally, a new study in Cardiovascular Research explored the link between PAD and psoriasis. Basically, uncontrolled psoriasis increased patients’ risk for disease because skin-damaging inflammation could also impact your arteries and heart. As such, sticking with psoriasis medications could lower the risk for PAD complications, the study concludes.

How is PAD Diagnosed?

If your vein specialist suspects you have PAD, you may need one or more of the following tests:

  • An ankle-brachial index (ABI), which determines your blood flow by comparing the blood pressure in your ankle to the pressure in your arm.
  • A Doppler ultrasound, which can detect blood vessel blockages with sound waves
  • A treadmill test, to detect whether leg cramps are associated with activity, and whether they resolve with rest

You may also need additional blood tests to check for related conditions like diabetes or high cholesterol.

Treating PAD

If you are diagnosed with PAD early on, you may be able to control your symptoms with a series of lifestyle changes. At our Houston and Dallas area vein clinics, we also help PAD patients by using minimally invasive procedures. Some of the treatment options we offer include Angioplasty, Stenting, and Atherectomy—the procedure we recommend for you will depend on the location of your blockages and the progression of your disease.

But want to know what they all have in common? These methods will almost always spare you from having major, open surgeries. Because of that fact, your recovery period will be drastically reduced. And you will likely be discharged from hospital on the same day of your procedure.

Before we come up with your treatment plan, however, we need to conduct diagnostic exams. And, in order to do that, we need to see you in the office. So, if you suspect PAD may be behind your leg cramps, or if you have any other PAD symptoms, schedule a consultation right away.

 

Sources: Journal of Environmental Research and Public Health, Clinical Interventions in Aging

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