Lower Extremity Arterial Disease

Atherosclerosis is a diffuse process that may affect any artery in the body and cause obstruction (some patients call these "blockages") of the involved blood vessel. When atherosclerosis blocks the arteries that provide blood supply to the legs, the patient may have difficulty walking long distances or, in severe cases, may even develop gangrene and require amputation of the leg.

In mild cases, the patient may sense pain or tiredness in the legs when walking. This symptom is called claudication. In mild cases, the patient may benefit from medication or from an exercise program to help improve blood flow to the legs. Exercise may also slow the progression of the disease in the legs and other arteries as well. If a patient is severely limited by disabling symptoms, it may be necessary to do procedures such as angioplasty or bypass surgery to relieve the symptoms and improve the ability to walk.

In severe cases of lower extremity ischernia (poor blood flow), the patient may develop gangrenous changes in the feet, nonhealing wounds, or infections. In these cases, it is usually necessary to perform a surgical bypass or angioplasty to get more blood supply to the legs to avoid amputation.

In the legs, as in other blood vessels, a variety of techniques may be used to open or bypass a blocked blood vessel. In some vessels, such as iliac arteries, balloon angioplasty may be used with or without metal stents to open the blocked vessel. In more complicated cases, a surgical bypass made of artificial material or a vein graft is used to bypass around the blocked section of the artery. We often use a combination of these procedures on patients who have multiple blocked arteries.

While surgery can dramatically improve a patient's lifestyle and prevent amputation for a time, surgery does not stop the progression of vascular disease and is not a permanent cure. It is still important for the patient to consume a healthy lowfat diet, exercise, avoid smoking, and have regular medical care to control other risk factors such a blood pressure and cholestrol.

For more information about vascular stents and other procedures, click here

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Last Updated: Tuesday, November 20, 2001 Rev A

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