Treating PAD

This is a common excuse heard from people who endure constant leg pain or cramps when walking, numb feet or toes, ulcers that do not heal, and color changes in the legs or feet. Oftentimes, these symptoms are the result of peripheral artery disease (PAD), which is a narrowing and hardening of the arteries in the lower extremities due to plaque build-up. According to the American Heart Association, this disease affects nearly eight million Americans. If left untreated, PAD can lead to heart attack, stroke, gangrene, high blood pressure, erectile dysfunction, and limb loss.

When patients visit The Florida Leg and Vein Center of Excellence, in affiliation with Florida Heart and Vascular Center, they are putting themselves in capable hands. Throughout the years, David C. Lew, M.D., FACS, FSCAI, and his talented team of cardiologists have provided countless PAD patients with superior delivery of care, safe and rapid interventions, and excellent outcomes.

“Many people with PAD experience leg pain (claudication) when they walk, and once they stop walking, the pain disappears,” Dr. Lew says. “It is caused by a reduction in the amount of blood that flows to the legs. Diabetics and smokers are at high risk, as well as those who suffer from high cholesterol, high blood pressure or have a family history of heart disease.”

Florida Heart and Vascular Center’s state-of-theart cardiac catheterization lab plays a key role in the diagnosis and treatment of peripheral artery disease. The lab is equipped with advanced technology, including digital imaging systems that allow the medical team to see the workings of the arteries with extraordinary clarity.

To determine whether a patient has PAD, Dr. Lew will perform an ankle-brachial index (ABI), described as a painless procedure that compares blood pressure in your feet with the blood pressure in your arm. From there, he utilizes either computed tomography angiogram (CTA), magnetic resonance angiogram (MRA), or an invasive angiogram to determine which arteries are blocked, the severity of the blockages, and condition of the vessels surrounding the blockage.

Several minimally invasive treatment options are available, depending on the severity of the condition. Angioplasty involves inflating a balloontipped tube at the site of the blocked artery to compress the plaque and widen the artery. The disease can also be treated with a stent, which is a small metal-mesh tube that is placed at the blocked site to prop the artery open, maintaining adequate blood flow. The cardiologists also utilize atherectomy, which removes plaque deposits in patients whose arteries are heavily calcified.

Dr. Lew says patients with peripheral artery disease frequently develop coronary artery disease. Fortunately, he and Dr. Jose Rosado, Dr. Sanjeev Bhatta, Dr. Patrick Williams, Dr. Leonard Victores, and Dr. Ilie Barb are vastly experienced in treating both diseases. Therefore, patients receive a continuum of treatment under one roof with cardiologists they are comfortable with and trust.

“It is an advantage for patients because we know their medical histories and what medications they are taking,” Dr. Lew says.