September is Peripheral Artery Disease Awareness Month, and a MedStar Montgomery Medical Center (Olney) vascular surgeon is encouraging people not to dismiss recurring leg pain or difficulty walking as simply a part of aging.
Peripheral artery disease, or PAD, occurs when plaque builds up in the arteries supplying the legs, reducing blood flow to the muscles and tissues. One of the most common symptoms is aching, cramping, heaviness or fatigue in the legs while walking that improves with rest.
“Unfortunately, many patients assume this is simply part of getting older and may live with these symptoms for years before being evaluated,” said Danielle Salazar, MD, a vascular surgeon at MedStar Montgomery Medical Center.
PAD can range from mild disease with few or no noticeable symptoms to more serious cases involving foot pain while at rest, decreasing ability to walk or wounds that do not heal. Advanced PAD can progress to chronic limb-threatening ischemia, in which inadequate blood flow puts tissue and the limb at risk.
According to Salazar, warning signs including a nonhealing wound, persistent foot or toe pain, changes in skin color or increasing difficulty walking should prompt an evaluation.
PAD can also indicate cardiovascular disease elsewhere in the body and is associated with an increased risk of heart attack and stroke. Evaluation can include an ankle-brachial index, or ABI, and vascular ultrasound to determine whether blood flow to the legs is impaired.
Treatment does not necessarily require a procedure. For many patients, initial treatment includes managing cholesterol, blood pressure and diabetes, quitting smoking when applicable, medications and a structured walking or supervised exercise program.
For patients with symptoms that significantly affect their quality of life, or those who develop rest pain or nonhealing wounds, treatment to restore blood flow may be necessary. Options can include minimally invasive catheter-based procedures or surgical bypass.
“Patients should not assume that difficulty walking or pain in their legs is just a normal part of aging,” Salazar said. “If something has changed, bring it up with your physician. PAD is treatable, and identifying it earlier gives us the greatest opportunity to keep patients walking, protect their limbs, and maintain their quality of life.”
