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Published on July 20, 2018

Vein Health: PAD, DVT and Uterine Artery Embolization

Vein and Artery HealthIn this Fox 8 House Call series, Cone Health experts explore vein health, including:

Peripheral Artery Disease

Peripheral Artery Disease (PAD) is a narrowing of arteries outside of the heart and brain, in the stomach, arms and most commonly the legs. Similar to coronary artery disease (CAD), PAD is caused by atherosclerosis, when plaque builds up in the wall of the artery. Plaque build-up can grow large enough to significantly reduce blood flow through an artery. When plaque becomes brittle or inflamed, it may rupture, triggering a blood clot to form that may either further narrow the artery or completely block it. If the blockage remains in the peripheral arteries in the legs, it can cause pain, changes in skin color, sores or ulcers and difficulty walking. Total loss of circulation to the legs and feet can cause gangrene and loss of a limb. If the blockage occurs in a carotid artery, it can cause a stroke.

Most people will experience the common symptoms of PAD, while some may never experience signs at all. The signs of PAD are often overlooked or thought to be caused by something else, leaving it to go undiagnosed. The most common symptoms of PAD involving the lower extremities are cramping and pain or tiredness in the leg or hip muscles while walking or climbing stairs. Typically, this pain goes away with rest and returns when you walk again.

Factors that increase your risk for developing PAD include:
• Smoking.
• Diabetes.
• High blood pressure.
• High cholesterol.

Your risk for PAD also increases as you age. People with peripheral arterial disease have a higher risk of coronary artery disease, heart attack or stroke, which is why it’s important to seek treatment if you experience symptoms. As with any disease, the more you understand, the more likely you'll be able to help your health care professional make an early diagnosis and start treatment. Fortunately, once PAD is suspected, it is easily diagnosed. Treatment may involve management through lifestyle changes and medication, or minimally invasive strategies such as balloon angioplasty, stenting and atherectomy.

Muhammad Arida, MD, is an interventional cardiologist with Cone Health Medical Group HeartCare.

Uterine Artery Embolization

Although many uterine fibroids do not cause harmful symptoms and do not require treatment, in some cases, uterine fibroids produce symptoms within a woman that cause discomfort and disruption of everyday life. When patients experience heavy bleeding, painful intercourse and pelvic pain caused by fibroids, treatment is needed to alleviate these symptoms. Uterine fibroid artery embolization is one of several treatment options available for uterine fibroids. Uterine fibroid embolization is a minimally invasive procedure that significantly reduces symptoms caused by uterine fibroids and serves as an effective option for those who do not want to undergo surgery.

During the procedure, an interventional radiologist or a vascular surgeon makes a small incision in the groin and inserts a catheter into an artery. The catheter is guided through the artery to the uterus while the physician watches the progress of the procedure using a moving X-ray. Tiny plastic beads, the size of grains of sand, are injected into the artery that is supplying blood to the fibroid. This process cuts off the blood flow to the fibroid(s), thus causing it to shrink.

Uterine fibroid embolization normally only requires a one-night hospital stay, carries low patient risk, and involves a quick recovery period—most patients are able to return to work within a week. Patients will check in with their surgeon once more during recovery, and then continue to follow up with their OB/GYN. For those who have been diagnosed with uterine fibroids, it is important to discuss treatment options with your doctor.

Gregory Schnier, MD, RVT, is a vascular surgeon at Alamance Vein and Vascular Surgery, PA and a member of Cone Health Medical Group.

Deep Vein Thrombosis

Deep vein thrombosis (DVT) is very common, with an average of about one thousand cases in our community each year. DVT occurs when a blood clot forms in a deep vein, most commonly in one of your legs, although they can form in the pelvis or arm. Anyone can develop DVT, but certain factors can put you at a higher risk, including:
Family history of DVT.
• Personal history of DVT.
• Prolonged immobilization or not moving for long periods of time. For example, extended bed rest or extended travel may keep you in the same position for a long period of time.

Symptoms of DVT will occur only in the affected area of the body, although not all individuals will experience them. The most common symptoms are:
• Swelling.
• Pain.
• Tenderness.

If you experience these symptoms, but you didn’t experience an injury that could have caused them, and you are at a higher risk of DVT, talk to your physician.

The main treatment method for DVT is a prescription blood thinner. The goal of treatment is to prevent the clot from growing or breaking loose and causing a pulmonary embolism. Many patients with DVT recover completely, although some can experience chronic, long-term swelling and heaviness in the affected area. To help prevent blood clots from forming, try to avoid sitting still by standing and moving around every hour or so. Regular exercise and wearing compression socks can also help prevent DVT in people who sit throughout the day or travel frequently.

Brandon Cain, MD, is a vascular surgeon with Vascular & Vein Specialists of Greensboro and a member of Cone Health Medical Group.

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