Vascular Surgeon Questions Peripheral Arterial Disease

I was diagnosed with Peripheral Artery Disease last week.Please advise.

I am a 35 year old man and I have been diagnosed with peripheral artery disease last week. What is the next course of action as far as my treatment is concerned? Can my condition be corrected completely?

12 Answers

peripheral artery disease, or PAD is a general terminology, indicating "blockage of arteries of the leg". There are marked difference in the severity of the disease and how you are affected depending on the severity of the disease. The most qualified physician to confirm the diagnose would be physicians who's practice is dedicated to treating patients with PAD; Vascular surgeon, Cardiologists who have specialized in treating PAD patients and other physicians who have dedicated themselves to treating patients with PAD. It is important to have your diagnosis confirmed by a specialist. The specialist should discuss with you the natural disease progression of the disease and the available treatment options. PAD cannot be corrected completely, but it can be managed successfully with life style changes and appropriated medications.
PAD is usually a chronic condition. Finding PAD in someone who is in their thirties is concerning. If this was found incidentally, a thorough medical evaluation should be done focusing on history of familial hypercholesterolemia, diabetes, HTN and smoking. If there is a smoking abuse history, in a young male in their thirties, the concern for Buerger's disease should be entertained and ruled out by exam, history and, sometimes, an angiogram. As mentioned above, PAD is not common in young people. Medical management and aggressive lifestyle modification is recommended reserving interventions for debilitating and limb-threatening conditions. Finally, the best way to halt progression of disease is through lifestyle
modification and compliance.
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You are a very young man to be diagnosed with peripheral artery disease as it is usually a disease of older individuals as it is basically atherosclerosis of the arteries of the legs usually (actually all the arteries in the body except the ones of your heart and your brain). This disease is more common in smokers so, if you smoke, the first course of action is smoking cessation. As for treatment, it really depends on the severity of your disease. Just as it takes a lot of "junk" to block a water pipe in your house, it takes a lot of plaque in your peripheral arteries to create a problem that requires fixing and in fact, you would only receive treatment if you had a blockage that was causing you symptoms. Symptoms of PAD are usually pain, specifically, pain with exertion and is called claudication. Walking more is one of the ways to help your body make new blood vessels to increase the blood flow to your legs. If you have symptoms and if you need treatment, there are ways to balloon and stent the arteries which many interventional cardiologists and radiologists do and there are bypasses that are surgical procedures performed by vascular surgeons. The treatments do NOT cure the disease; they just solve the problems created by the blockages in the arteries. There are ways to slow the progression of atherosclerosis of your arteries and you can discuss these with your PCP.

KathyLee Santangelo, MD
Unless you have a genetic predisposition and/or were an extremely heavy smoker, the diagnosis of PAD in your age is really unusual. I would make certain that you saw a vascular surgeon and had proper vascular testing by him before I would have anything done.
It depends on how bad the PAD disease is.
You are young and if your symptoms are not severe then the medical management with regular walking, usually Aspirin and statins are the early disease management.
You need to control all of the risk factors that cause hardening of the arteries, or atherosclerosis. If you smoke, you need to stop, control diabetes to A1c less than 7, take a statin, baby asa, and an ace inhibitor for hypertension if you have that.
The first line treatment is medical management and risk factor modification and you will need to schedule an appointment with a vascular specialist.

Thanks,

Ramandeep Sidhu, MD, FACS, RPVI
If you smoke, quit smoking for sure. Your MD will also likely start you on a medical mgt regime (aspirin and statin) if indeed you do have PAD.
It is extremely rare for a 35 yo to truly have peripheral artery disease. What kind of testing was done to say you have this and what kind of symptoms are you having that prompted testing?
Get your weight down. Eat a plant based diet. Get your cholesterol treated aggressively. See a cardiologist about cholesterol management. Exercise frequently.
These are all good questions. My recommendation is that you seek consultation with a Board Certified Vascular Surgeon. Your condition is very amenable to treatment with lifestyle change and risk factor management. Intervention may be considered depending on your individual situation.


David Fox, MD, FACS, RPVI
Next step is to see an expert in vascular disease, a vascular surgeon.