Peripheral Artery Diseases: Diagnosis & Treatment

Overview

Peripheral artery disease affects the arteries supplying blood to the legs. The Peripheral Artery Diseases & Limb Preservation Program brings together physicians from multiple specialties, including vascular and endovascular surgeons. The multidisciplinary team treats patients with peripheral artery diseases, also known as peripheral vascular diseases, that can potentially lead to amputation of a limb.

The Peripheral Artery Diseases & Limb Preservation Program coordinates individualized treatment plans to quickly and effectively treat peripheral artery diseases and to avoid amputation, thus preserving limbs.

What We Treat

Peripheral artery diseases can lead to severe leg pain and tissue loss, which can result in amputation. However, the need for amputation is significantly decreased when patients seek early treatment, at the first signs of symptoms.

The recognized causes of peripheral artery diseases include:

Diabetes
Hypertension
High cholesterol
Smoking.

These factors can cause an inflammation in the arteries, which leads to the blood vessels closing or dilating.

Common peripheral artery diseases include:

Vascular obstruction: When blockages in the blood vessels prevent blood from reaching the organs or muscles.
Aneurysm: When a blood vessel dilates up to a point at which it may rupture.
Diabetic foot syndrome: A complication from diabetes resulting in open wounds and ulcers that are difficult to treat.

Treatment options for peripheral artery disease include vascular or endovascular surgery, as well as catheter interventions. These treatments aim to reestablish effective blood circulation, and/or to prevent blood vessels from rupturing.

Diagnosis & Treatment

Diagnosis of Peripheral Artery Diseases

Diagnosis for patients affected by peripheral artery diseases includes a thorough clinical vascular exam, Doppler ultrasound study, tissue oxygenation measurement, and wound care assessment. The main symptom of peripheral artery diseases is leg pain, and patients will often have experienced tissue loss and open leg wounds or ulcers.

Early Diagnosis is Essential.

Diabetic foot syndrome is a serious problem in the Gulf region, where the incidence of diabetes is high, and early diagnosis and treatment is essential. Patients often reach Cleveland Clinic Abu Dhabi at a late stage of the disease, when a significant amount of foot tissue is already lost and infection has already started. Outcomes are significantly improved when patients seek help when experiencing early symptoms of the disease, such as leg pain, discoloration of the foot or leg, and small wounds or ulcers of the foot.

Only in the early stages can minimally invasive treatment methods successfully be used to avoid amputation.

Treatment for Peripheral Artery Diseases & Limb Preservation

Treatment for peripheral artery diseases varies depending on the patient.

For diabetic foot syndrome, a specialized team dealing with foot problems in diabetes patients creates an individualized treatment plan. The treatment plans usually include infection control with antibiotics, improvement of blood flow to the limb, limited removal of dead tissue, and healing support with casts and specially designed boots or shoes. Treatment may require surgery on affected areas, and sometimes the amputation of toes. This is the first step in treatment to help prevent the infection from spreading.

If arterial obstructions are present, the blockages are treated with non-invasive techniques such as catheter-based artery dilatation (angioplasty) using balloons and stents, or recanalization (atherectomy), using drilling and suctioning devices to remove blockages from the artery.

For extensive artery blockages, bypass surgery may be needed, and is performed with the most advanced materials and techniques. After surgery, the patient will be referred to the outpatient clinic to prevent the disease from recurring. Outpatient treatment can include podiatric care, orthotic support, and wound care.

Patients with peripheral aneurysms are treated using catheter procedures, such as covered stents, or by surgical resection and implantation of a synthetic graft/tube. These operations help prevent blood vessels from rupturing.