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PAD evaluation and treatment

Peripheral arterial disease is a common health problem in which the arteries that carry blood to the legs or arms become narrowed or clogged, preventing the normal flow of blood. PAD sometimes causes pain, but all-too-often it causes no symptoms. Of Americans over 65, 12-20% have PAD, but only one-third display symptoms, which include pain while walking that subsides during rest, leg cramps, numbness, coldness of lower legs and feet, skin ulcers, and blotchy or darkened skin. PAD can occur at any age, but is most common in people age 50 and older. Its most common cause is atherosclerosis, in which plaque (cholesterol and scar tissue) gradually clogs the blood vessels. The presence of PAD can be an alarm that plaque is clogging arteries elsewhere in the body, so its early detection is key in preventing stroke, heart attack, and other life-threatening conditions.

The Society of Interventional Radiology recommends routine testing in all people age 65 and older, and in all people who display symptoms. The diagnostic imaging used to test for PAD may depend on your particular circumstances because the options are many, including vascular ultrasound, Doppler ultrasound, CT angiography, MR angiography, or specialized x-ray with a contrast agent to show blood vessels in detail (fluoroscopy).

Treatment for PAD includes lifestyle changes, dietary modifications, smoking cessation, and regular exercise. When required to restore blood flow, your MIT radiologist can provide outpatient procedures including angioplasty, wherein a catheter is threaded into the affected artery and a small balloon is inflated inside to reopen it; stent therapy, where an expandable permanent stent is installed to keep the vessel open; or an atherectomy, where a small blade or laser is used to remove arterial plaque.