Peripheral artery disease (PAD) is a health condition that occurs with atherosclerosis, the buildup of fatty plaque deposits in the arteries. These deposits cause the arteries to become narrowed or blocked, reducing blood flow to the limbs. It primarily affects the legs, but can affect the arms as well. PAD can lead to very serious health complications if it isn’t managed. In some severe cases, untreated PAD can lead to the need for amputation.
Why Can PAD Lead to Amputation?
One of the most advanced stages of PAD is critical limb ischemia (CLI). In this stage of the disease, blood flow to the limbs may be so severe and widespread that amputation is needed and complications can be life-threatening.
Some important facts about PAD and amputation risk:
- 11% of people with PAD develop CLI.
- The amputation rate among people with CLI is around 25%.
- People with CLI are also at increased risk of dying from cardiovascular disease.
- People who have both PAD and diabetes are at particularly high risk for amputation.
- Half of the amputations that occur each year in the U.S. are due to diabetes and PAD.
- 60% of patients who have an amputation due to PAD or CLI die within 2 years—a higher mortality rate than for patients with breast, colon, and prostate cancers.
Symptoms of CLI
Symptoms of PAD include:
- Cramping, pain, weakness, or numbness in the hips or legs, especially with physical activity
- Cold sensations in the lower legs or feet
- A change in leg color
- Slow toenail growth
- Hair loss or slowed hair growth on the legs and feet
- Weakened pulse in the legs or feet
- Arm cramping
- In men, erectile dysfunction
When PAD progresses, there can be a number of different symptoms that indicate CLI. Leg pain, especially while walking, is common even at early stages of PAD, but leg pain that is intolerable and intense may be a sign of CLI. CLI-related leg pain can be so severe that it disrupts sleep. Ulcers or wounds that won’t heal after more than two weeks, even leading to gangrene, are another symptom of CLI.
If you have symptoms of PAD or CLI, you should see a vascular specialist urgently.
Who is at Risk of Amputation from PAD?
Anyone who has developed PAD or CLI could be at risk for amputation, but risks are increased for some groups of people. These high risk groups include people with diabetes, and some minority groups including African Americans and Hispanic patients.
PAD Prevention and Early Stage Management
The most important steps you can take to prevent PAD include many things that also improve your overall health. Try to reach and maintain a healthy weight, quit smoking, and get regular physical activity. Eat a healthy, balanced diet high in whole foods and low in excess sodium, sugar, and saturated and trans fats.
Managing chronic conditions is especially important if you have PAD. Some health conditions that increase the risk for PAD include diabetes, chronic kidney disease, high blood pressure (hypertension), high cholesterol (hypercholesterolemia), and obesity. If you’re on medications for any chronic conditions, it’s important to take them as prescribed and follow other treatment recommendations from your doctor.
But there are some PAD risk factors that can’t be controlled through lifestyle changes. African Americans and Hispanic people, and people over 60 years of age are at increased risk, as are people who have a family history of heart disease.
How Can You Stop PAD from Progressing to CLI?
If you have PAD, making sure it’s properly treated is critical to reduce your risk for complications like CLI and amputation. Consult a trusted vascular specialist about all your treatment options and recommendations. With proper treatment, you can avoid the progression of PAD. Early management of PAD can include the above lifestyle changes, as well as supervised exercise therapy, and medications.
There are also minimally-invasive vascular treatments recommended for people who have PAD. At Beach Wellness MD, we specialize in minimally-invasive PAD procedures, including balloon angioplasty, atherectomy, and stenting. These procedures all have the goal of opening narrowed or blocked peripheral arteries to increase the needed blood flow to the limbs. They are all offered as outpatient procedures, so after a period of medical observation, you can safely go home the same day.
Consult a Trusted Vascular Specialist!
If you have PAD, amputation is a real risk, but it can be avoided by making sure that you prevent the disease from progressing. At Beach Wellness MD, we’re here to work with you on a comprehensive and personalized PAD treatment plan.
Dr. Ali Golshan, MD, is a leading vascular expert who specializes in PAD and other vascular conditions. Dr. Golshan emphasizes one-on-one treatment and designs personalized care plans for each patient.
Contact us today to schedule your appointment.