Peripheral Arterial Disease (PAD)
Michael N. Tameo, M.D.
Ronald L. Nath, M.D. , F.A.C.S.
to Dr. Begos
who was selected again as one of of Boston’s top doctors by Boston Magazine in 2015
CSA Vein Center
receives accreditation by the IAC:
CSA is the first vein practice in Northeast Massachusetts to be fully accredited as a Certified Vein Center by the IAC (Intersocietal Accreditation Commission).
Peripheral arterial disease (PAD, or PVD for peripheral vascular disease)
refers to the build-up of atherosclerotic (cholesterol) plaque within the
peripheral arteries such that symptoms occur from lack of blood flow. The
arteries in the legs are most commonly affected. The symptoms can include
claudication (pain with walking), pain at rest in the feet or toes, and tissue
loss, which includes ulcers, wounds, gangrene, and infection.
Complications from PAD include acute thrombosis (occlusion from blood clot formation) and
embolism, which is when thrombus (blood clot) or plaque from higher up in an
artery or the heart breaks loose and lodges itself into an artery further
downstream. These complications can cause sudden severe pain,
limb-threatening ischemia, and gangrene and/or infection. This can result in
loss of toes or limbs.
Diagnosis and management of PAD requires a thorough history and physical
exam by a vascular surgeon. An ultrasound and/or non-invasive arterial
study, which we perform at our office in our accredited non-invasive
vascular lab, is often required. Patients can receive the required test and
be seen by their vascular surgeon at the same visit. Occasionally, a
computed tomography (CT) scan, magnetic resonance imaging (MRI) study, or
arteriogram (injection of contrast dye into the arteries) is required.
Treatment of symptomatic PAD may involve medical therapy along with an exercise regimen, minimally invasive (endovascular) treatment with balloon angioplasty and/or stenting, or open surgical reconstruction with a graft.