THINGS TO KNOW ABOUT Peripheral Artery Disease Diagnosis & Treatment
Symptoms of peripheral arterial disease
Peripheral arterial disease (PAD) is a common condition where a build-up of fatty deposits in the arteries restricts blood supply to leg muscles. It's also known as peripheral vascular disease (PVD).
Causes of peripheral arterial disease
Many people with PAD have no symptoms. However, some develop a painful ache in their legs when they walk, which usually disappears after a few minutes' rest. The medical term for this is "intermittent claudication".
The pain can range from mild to severe, and usually goes away after a few minutes when you rest your legs.
Both legs are often affected at the same time, although the pain may be worse in 1 leg.
Other symptoms of PAD can include
• hair loss on your legs and feet
• numbness or weakness in the legs
• brittle, slow-growing toenails
• ulcers (open sores) on your feet and legs, which do not heal
• changing skin colour on your legs, such as turning pale or blue
• shiny skin
• the muscles in your legs shrinking (wasting)
The symptoms of PAD often develop slowly, over time. If your symptoms develop quickly, or get suddenly worse, it could be a sign of a serious problem requiring immediate treatment.
Complications of peripheral arterial disease part 1
PAD is a form of cardiovascular disease (CVD) because it affects the blood vessels.
It's usually caused by a build-up of fatty deposits in the walls of the leg arteries. The fatty deposits (atheroma) are made up of cholesterol and other waste substances.
The build-up of fatty deposits on the walls of the arteries makes the arteries narrower and restricts blood flow to the legs. This process is called atherosclerosis.
There are certain things that can increase your chances of developing PAD and other forms of CVD, including:
• smoking – the most significant risk factor
• type 1 diabetes and type 2 diabetes
• high blood pressure
• high cholesterol
• growing older
Complications of peripheral arterial disease part 2
PAD is not immediately life-threatening, but the process of atherosclerosis that causes it can lead to serious and potentially fatal problems.
Coronary heart disease (CHD)
The blockages in the arteries in the legs can also affect other areas of your body, such as the arteries supplying the heart and brain.
This means that having PAD makes you more likely to develop another form of cardiovascular disease (CVD), such as:
• coronary heart disease
• heart attack
Critical limb ischaemia (CLI)
If the blood flow to the legs becomes severely restricted, critical limb ischaemia (CLI) can develop. CLI is an extremely serious complication that can be challenging to treat.
Symptoms of CLI include:
• a severe burning pain in your legs and feet that continues even when you're resting
• your skin turning pale, shiny, smooth and dry
• wounds and ulcers (open sores) on your feet and legs that do not heal
• loss of muscle mass in your legs
• the skin on your toes or lower limbs becoming cold and numb, turning red and then black, and/or beginning to swell and produce smelly pus, causing severe pain (gangrene)
If you think you're developing symptoms of CLI, contact a GP immediately. If this is not possible, telephone NHS 111 or your local out-of-hours service.
An angioplasty or bypass graft is usually recommended if you have CLI, although these may not always be successful or possible. In a few cases, an amputation below the knee may be required.
TemRen Atherectomy Device
Temren atherectomy with CTO catheter has a revolutionary tip design that can both cut and trim diseased tissue segment. It cuts, captures, and clears diseased tissue by aspiration with the Archimedes screw principle with one insertion. Temren treats a broad range of tissue types, from soft plaque to calcified arteries, and can be used for lesions above and below the knee. It has a novel tip design that centres the active tip of the device in vessel and minimises the risk of rupture.
The Temren was designed with the intention of reducing the risk of distal embolization and negative vessel interaction, of obviating the need for removal of the device from the body during the procedure to purge collected debris, and of avoiding adverse effects (such as excessive blood removal and vessel suck-down) related to the use of aspiration.
Unlike other directional devices, which must be withdrawn periodically for removal of debris from the nose cone, since the Temren continually captures and clears debulked material, it can perform an entire debulking procedure with one single insertion; or sequential single insertions can be employed with catheters of progressively increasing diameter.
Extender is a drug-eluting balloon dilatation catheter designed for percutaneous transluminal coronary angioplasty (PTCA) and has been optimized for the treatment of patients with coronary arterial disease. Extender PTCA catheter is indicated for the dilatation of the affected segments of a coronary artery or a coronary bypass in order to enhance myocardial perfusion. This paclitaxel-eluting balloon feature a proper coating technology which consistently delivers paclitaxel, an anti restenotic drug during very brief inflation times, while also minimizing washout of the drug during delivery and placement of the drug-eluting balloon. Balloon catheter offers excellent pushability, trackability and crossability due to a low balloon profile, low tip entry profile and hydrophilic coating on the distal shaft of the catheter. Paclitaxel eluting coronary balloon catheter is especially indicated for the treatment of coronary in-stent restenosis.