When you think of the term heart disease, what symptoms come to mind?
For many people, it’s chest pain, shortness of breath and even heart attack — signs of the most common form of heart disease, called coronary artery disease. These symptoms are caused by fatty deposits called plaque which can build up in the arteries around the heart, causing a narrowing or blockage that can restrict blood flow.
But the arteries that carry oxygen-rich blood away from your heart — to your legs, arms and major organs like the brain — can also become clogged with plaque. This type of heart disease, called peripheral artery disease (PAD), affects approximately 200 million people globally.
What are the symptoms of PAD?
The classic symptom of PAD is pain in the legs during physical activity that gets better after rest, says Michael Jaff, M.D., chief medical officer and vice president of Vascular Therapies at Boston Scientific. “Patients often say things like, ‘I can’t walk as far or as fast as I used to because my legs bother me,’ or ‘I’ve got a sore or a wound on my foot that isn’t healing and is very painful,’” he says.
PAD that goes untreated increases your risk for leg and foot problems and serious complications, such as heart attack, stroke or limb loss. The warning signs include:
-
Pain, cramping, aching or a feeling of heaviness in your legs (including your buttocks, thighs and/or feet) when you’re active that goes away after rest
-
Pain in your legs or feet while resting (which can also be a sign of an advanced form of PAD called chronic limb-threatening ischemia)
-
Muscle atrophy or numbness in your legs or feet
-
Sores or wounds on your toes, feet or legs that don’t heal (or heal slowly)
-
Skin that’s cool to the touch and/or cold or numb toes
-
Leg hair loss
-
Lack of growth of your toenails
-
Changes in skin color (pale, bluish or reddish)
Unfortunately, too many patients don’t know that these are signals of PAD, says Dr. Jaff. “They mistake the symptoms for sciatica, a pulled muscle or getting older,” he says. “Physicians are also far less trained in identifying peripheral artery disease than they are coronary artery disease, so symptoms may be missed.” Some people with the condition may have no symptoms at all.
Lifestyle changes, such as quitting smoking, eating a heart-healthy diet, managing stress and staying physically active can go a long way toward lowering your risk of PAD.
How is PAD treated?
For years, the standard treatment for PAD was bypass surgery, during which a surgeon sews a healthy blood vessel above and below the blocked artery, rerouting blood flow so it reaches the leg and foot.
But bypass surgery comes with challenges, says Dr. Jaff.
“It can take up to five hours, which isn’t ideal for patients who have coronary disease and are more likely to suffer heart attacks during or after the procedure,” he says. “It also involves an incision along the length of the leg, which can be tough to heal.”
Recently, a less invasive procedure has become more common: angioplasty. During this outpatient procedure, which typically lasts 30 to 90 minutes, a physician uses a catheter with a tiny balloon on its end to open areas of plaque causing blockages. Angioplasty is often followed by placement of a stent, which is like a metal scaffold placed inside an artery to keep it open and maintain blood flow.
However, physicians are up against a new challenge these days. The aging population and an increase in patients with diabetes and kidney disease mean plaque buildup in arteries is often now rock-hard rather than fatty, soft and pliable.
“Physician innovators had to come up with a new way to deal with this kind of calcified plaque,” says Dr. Jaff.
How the SEISMIQTM IVL technology is creating a better future for PAD patients
The result? A technology called intravascular lithotripsy (IVL). During an IVL procedure using the SEISMIQTM IVL System, laser-generated sound waves pulse with consistent acoustic pressure inside a balloon catheter that’s inserted into the arteries to break up hardened plaque and relax the blood vessel.
“The beauty of IVL is that it doesn’t carry as many risks as other ways physicians have tried to get rid of calcified plaque,” says Dr. Jaff. Those methods include drilling the plaque out of the artery, which can lead to pieces breaking off and traveling down into the lower leg and foot, causing more blockages.
With the SEISMIQ system, physicians have a new option for treating complex calcified disease, which is a severe form of PAD. The results have been so impressive that clinical trials are currently underway for the SEISMIQ technology to be used to treat coronary artery disease.
“Not so long ago, we didn’t have a lot of long-lasting treatments for patients with severely calcified plaque,” says Dr. Jaff.
“Now, with the SEISMIQ IVL system, angioplasty and stenting, we’re giving the patient results that are as promising as if they didn’t have calcified plaque to begin with,” says Dr. Jaff. “It’s remarkable.”
Learn more about peripheral artery disease and its treatments.