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Lifestyle Changes Remain Important in Fighting Peripheral Arterial Disease (PAD)
Date:10/21/2009

n. Since plaque blocks the leg arteries first, PAD is considered a red flag for several life-threatening vascular diseases, such as heart attack (the number one killer in this country) and stroke; it can also result in the loss of limb(s). PAD causes a range of symptoms, from no symptoms to pain in the legs while walking (intermittent claudication) to its most severe form that results in pain in the feet/legs at rest that can progress to ulcers (sores/wounds on the feet and toes) and eventual gangrene (black discoloration of the toes or feet; also called critical limb ischemia). The disease's progression can result in limb loss and even in death.

In the study, 918 patients had leg angiograms (an X-ray exam to diagnose arterial blockage and other problems). Of these, 122 patients (54 percent male, average age 70 years) had an arterial narrowing (50 percent) or blockage without any corresponding leg symptoms, said Keeling. These patients were followed over a maximum of nine years to determine if they developed any symptoms and to see if they required any treatment for their PAD in the form of angioplasty, stenting, surgical bypass or amputation. One-third of the 122 patients developed symptoms of pain or ulceration and almost half of these then required treatment. Overall, only 13.9 percent of the initial group required treatment, so even though PAD progressed over time, the researchers did not believe they had enough evidence to advocate early minimally invasive treatment of PAD in patients who had no initial symptoms, said Keeling. The fact that most of the 122 patients remained asymptomatic may be related to the intense risk factor modification they underwent or other factors as yet unidentified, said Keeling. "We know that many patients have blockages in their leg arteries but may not develop symptoms. We don't know yet what causes symptoms to develop in some but not in others. We are continuing our research in this area," she added.

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SOURCE Society of Interventional Radiology
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