Vascular Diseases & Treatment

What is carotid artery disease? 

Carotid artery disease is a condition in which the carotid arteries become narrowed or blocked. The carotid arteries provide the main blood supply to the brain. They are located on each side of your neck, and you can feel their pulse under the jawline. 

Carotid artery disease occurs when a sticky, fatty substance called plaque builds up in the inner lining of the arteries. The plaque may slowly block or narrow the carotid artery or cause a clot (thrombus) to form more suddenly. Clots can lead to stroke. 

 

Symptoms 

• Blurred vision

• Confusion

• Loss of memory

• Loss of sensation

• Problems with speech and language

• Vision loss

• Weakness in one part of your body 

 

Treatment 

• Medication: Blood-thinning medicines such as aspirin, clopidogrel (Plavix) and warfarin (Coumadin) may be administered to lower your risk of stroke. Medications to lower cholesterol levels and blood pressure may also be prescribed. 
• Carotid Endarterectomy: Carotid endarterectomy is a surgery that removes fatty deposits (plaque) that are narrowing the arteries in the neck.
• Carotid Angioplasty and Stenting: Carotid angioplasty and stenting are done through a small incision in the groin. A catheter (a flexible tube) is carefully moved up to the blockage in the carotid artery. The surgeon will then move a wire through the catheter to the blockage. Another catheter with a very small balloon on the end will be pushed over this wire and into the blockage. The balloon is then inflated, opening the artery and sending proper blood flow to your brain. A stent (a wire mesh tube) may also be placed in the blocked area. 

 

What is peripheral artery disease? 

Peripheral artery disease (PAD), also known as peripheral vascular disease, is a blood vessel condition that can cause the arteries that supply blood to the legs and feet to narrow and harden. As a result, when the muscles of your legs are working hard (such as during exercise), they cannot get enough blood and oxygen. Eventually, there may not be enough blood and oxygen, even when the muscles are resting. 

People are at higher risk of developing PAD if they have a history of: 

• Abnormal cholesterol

• Diabetes

• Heart disease (coronary artery disease)

• High blood pressure (hypertension)

• Kidney disease involving hemodialysis

• Smoking

• Stroke (cerebrovascular disease) 

 

Symptoms 

• You may experience pain, achiness, fatigue, burning or discomfort in the muscles of your feet, calves or thighs. These symptoms usually appear during walking or exercise and go away after several minutes of rest. 

• Your legs or feet may feel numb when you are at rest. The legs also may feel cool to the touch, and the skin may look pale. 

• When peripheral artery disease becomes severe, you may have:

  • Impotence

  • Pain and cramps at night

  • Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful

  • Skin that looks dark and blue

  • Sores that do not heal

 

Treatment 

• Medication: You may be prescribed high blood pressure medications and/or cholesterol-lowering medications. It’s important to make sure that you take the medication as recommended by your healthcare professional. Not following directions increases your risk for PAD, as well as heart attack and stroke. In addition, you may be prescribed medications to help prevent blood clots. 
• Angioplasty and Stenting: Angioplasty or stent placement (as is done in the heart for coronary artery disease) are nonsurgical procedures. A doctor will make a small incision and insert a catheter into it to reach the blocked artery. A tiny balloon is then inflated inside the artery to open the clog. A stent, a tiny wire mesh cylinder, may also be implanted at this time to help hold the artery open. Sometimes the catheter can deposit medicine or a special device into the artery to remove a clot. 
• Atherectomy: Atherectomy is a procedure to remove plaque from the artery. If a long portion of artery in the leg is completely blocked and a patient is having severe symptoms, surgery may be necessary. A vein from another part of the body can be used to “bypass” and reroute blood around the closed artery. 
• Limb Salvage: For patients with advanced PAD, our team actively works to open the arteries in the legs through a variety of procedures and therapies. These treatments can increase blood flow, allowing wounds on the lower extremities to heal as well as preventing the need for amputation.