Left Untreated, Peripheral Arterial Disease Can Result in Major Medical Complications
We’ve all heard of strokes and heart attacks. But lesser-known peripheral arterial disease can also cause serious problems, including the loss of a limb.
It’s widely known that a blocked artery can damage your heart during a heart attack or your brain during a stroke. But similar blockages from peripheral arterial disease (PAD) are also possible elsewhere in your body.
As Gayle Martin can attest, these blockages can cause intense, ongoing pain, and having them removed can change your life. Martin had suffered from a variety of leg ailments that made standing, much less walking, incredibly difficult. The most severe pain was in her leg, and, at times, it extended up into her hip.
Peripheral arterial disease caused a decade of pain
Image on the left shows the patient's peripheral arterial disease, while the right image shows the same arteries after a procedure that greatly improved the patient's blood flow.
Martin thought her bad knees or an irritated sciatic nerve were causing the problem.
“I’d suffered for 10 years,” she says. “I wasn’t able to walk to do any shopping—even grocery shopping. I’d have to lean on the basket in the store to make it through and depended on other people to do most of my grocery shopping.”
She feared that someday she wouldn’t be able to walk at all. Even standing in her kitchen to cook was difficult.
When she started experiencing chest pain, she went to The Moses H. Cone Memorial Hospital for a cardiac catheterization and stent. Jonathan Berry, MD, a cardiologist with Cone Health, performed the procedure. During the treatment, he fed the cath device through an artery in her leg, but he ran into blockages there. After the procedure, Berry asked Martin if she was experiencing any leg pain.
“Nobody had asked me that,” Martin says. “I’ve always told everybody that I had leg pain.”
Berry said she had severe blockage from peripheral artery disease in both legs—but told her that he could fix it.
“That was the most wonderful news I’d ever heard,” she says.
Treating peripheral arterial disease
Berry conducted a series of tests and discovered that both of Martin’s iliac arteries were almost completely blocked with cholesterol buildup called plaque. Peripheral arterial disease was preventing Martin’s legs from getting enough oxygen, which resulted in a buildup of lactic acid in her legs that caused intense pain. Left untreated, the circulation in her legs eventually could be completely cut off, resulting in gangrene and the loss of the affected limb.
But that was not going to happen to Martin.
“The procedure was flawless,” says Berry, who estimates he’s performed similar treatments for peripheral arterial disease more than 8,000 times. “There were no complications.”
A couple of hours after the procedure, a nurse came to Martin and helped her stand up.
“The first time I got up on my legs, the pain was completely gone,” she says. “It was like a miracle. It was just unreal.”
Before the procedure, a nurse had told Martin that the pain in her hip would probably go away, too. Martin didn’t believe her. But the pain was gone—and it still is.
Tip of the iceberg
Today, Martin does her own grocery shopping. And when she does her shopping, she has a different perspective.
“I’ve noticed since [the procedure] how many people you see walking and limping,” she says. “I never realized how many people had problems like that, and some of them could have the same problem I had and not be aware.”
“There are a lot of people walking around with discomfort in their legs,” he says. “They never talk to their doctor about it, so they live a life of discomfort.”
Pain is only part of the problem, and it could be a sign of larger issues.
“If you‘ve got blockages in your legs, the likelihood of having blockages in your heart goes up tremendously,” says Berry.
Initial testing for peripheral arterial disease is easy. A doctor feels for a pulse in the foot, compares the blood pressure in the leg to that in the arm, checks whether the foot feels cold, looks for discoloration in the foot, and asks the patient about leg pain. Subsequent tests, like a Doppler study, are simple and noninvasive. If further tests are needed, a minimally invasive angiogram can provide definitive information about the location and severity of blockages.
“For me, the moral of the story is that we’re just seeing the tip of the PAD iceberg,” says Berry. “For every patient that comes to medical or clinical recognition, there are probably 10 others out there with that disease that are never recognized.”
Martin now finds work around the house to be much easier.
“It would take me three times as long to do my daily chores,” she says. “I would have to sit down because of my legs. Now I can stand and cook. I have a new life.”
Physicians and care teams at Cone Health's Heart & Vascular Center have broad expertise and extensive experience in treating peripheral artery disease. Ask your primary care doctor for a referral to a Cone Health specialty care provider if you have concerns about peripheral artery disease.