Dr. Billy Kim, a Vascular Surgeon with The Surgical Clinic, treats patients experiencing Peripheral Arterial Disease (PAD). Statistics indicate that 14-20% of adults in the developed world have a chronic lack of blood flow to the legs. This blood flow impediment comes from atherosclerotic arterial disease. In terms of the two types of symptoms Intermittent Claudication (IC) and Critical Limb Ischemia (CLI), most deaths associated with PAD come from CLI.

The Risk for the Elderly

In the past few years, the elderly population has seen an increase in the incidence of chronic lower extremity ischemia. As a result, more patients face disabilities affecting their legs and an increased chance of amputation. In addition, they are at increased risk of morbidity and mortality due to cardiac and cerebrovascular ischemic events.

Many patients and the general population do not correlate the risk factors for heart and stroke disease with peripheral arterial disease. However, the same disease process of atherosclerosis affects all the arteries in the body.

Intermittent Claudication (IC) looks like general pain in the leg muscles following activity. It is the earliest and most common presentation of chronic lower extremity ischemia. The main symptoms of this condition include localized pain in the calf, thigh, and buttock muscles. However, these locations can change depending on the distribution of arterial disease and compromise.

Symptoms of Stenosis

As the level of stenosis (tightness) and disease progress in severity, the patients start to develop pain at rest. Usually, patients complain of pain at night, usually when elevating their legs in bed. In this case, relief can be found by activities such as walking or sleeping while hanging off the bed.

In contrast to IC, ischemic rest pain typically affects the foot. As this progresses further, severe tissue hypoperfusion continues, resulting in ischemic ulceration and gangrene. CLI includes rest pain and tissue loss and is associated with an annual mortality rate of 20%.

The purpose of awareness, education, early evaluation and possible intervention is to modify the progression of chronic lower extremity ischemia and reduce the incidence of other adverse vascular events. This also includes identification of risk factors, lifestyle modifications, pharmacotherapy, and other forms of noninterventional treatment such as exercise rehabilitation and physiotherapy. To a lesser extent, invasive procedures would include percutaneous interventions and surgery.

Visit The Board-Certified Surgeons at The Surgical Clinic

At The Surgical Clinic, board-certified vascular surgeons are trained and equipped to assess, identify and provide various treatment options for our patients. This may include conservative risk and behavior modifications, pharmacologic agents. Depending on the severity of IC and CLI, the next steps may include invasive interventions which we will provide the full spectrum of treatment tailored to the needs of the patients.

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