Avoiding Leg Amputations Due to Peripheral Arterial Disease QA
MUSIC My name is Thomas Reifsnyder, and I'm avascular surgeon at Johns Hopkins. MUSIC My job as a vascular surgeon basically isone of eduion. Every patient that we see we try toedue not only about their disease but about whatthe treatment options are. And I try to guide them to what would be the best treatment modality fortheir disease.
MUSIC One of the things that absolutely amazes me is that people will undergo anamputation of their lower extremity and not get a second opinion before their leg isremoved. Peripheral arterial disease requires a lotof expertise and a lot of experience to be able to treatthebest fashion. I frequently get phone calls fromphysicians and family members of patients.
Telling me that their loved one is goingto require an amputation. And when I see those patients as a secondopinion. Frequently the repair or the re, or thenecessary surgery to save that limb is known as, it, is easily done and something that can absolutely change thepatient's life. Its much better than to do a fairlysignificant operation and save a limb than it is to undergo anamputation. Many surgeons and many physicians outthere
believe that an amputation solves theproblem. You can get an, a prosthesis and you'll beable to walk again. And you don't have to undergo multipleprocedures to try to save that limb. Most patients can actually undergo one ortwo sophistied operations and save a limb, which will absolutelychange their life. Peripheral Arterial Disease which, whichused to be called Peripheral Vascular Disease basically is blockage of thearteries going to an extremity. Technically, it could involve blockage ofarteries going to the arm or hand.
But that's uncommon. The most common is blockage to the lowerextremities. Millions of Americans have peripheralarterial disease. The most common presentation is nosymptoms whatsoever. In other words, they go to their ,and the cannot feel their pulses. There are millions of peopleAmerica who have decreased circulationtheirlower extremities, but because they're getting older, they'renot
as mobile, they don't have any symptomswhatsoever. Those patients we don't typically see as avascular surgeon. The more common presentation for a patientwith peripheral arterial disease, is someone who develops paintheircalves or legs when walking. That is called lower extremityclaudiion. In the past, we didn't treat that veryaggressively because it's not a threat to the patient's life orlimb. Howeverthis day and age where we havea variety of minimally invasive
Peripheral Artery Disease Risks Warning Signs
Silence gt;gt; Perhaps one of the areas that El Camino will become best known for is treatment ofperipheral arterial disease. And basically what that is, isblocked arteriesthe legs. This is a problem that affects at least 20 millionpeopleAmerica. It's thought to impact 5 to 10 %
of individuals 55years of age and older. And it's probably the strongestmarker of risk for heart attack and strokepatientsin America. The testing to determine whethersomeone has peripheral arterial disease is really simple. It can be done with ablood pressure cuff. The treatment is very effective. And it also is importantto recognize this
because obviously it thenturns our eye on the heart and the brain and makessure that we're doing all of the things that we should do to prevent majorproblems for our patients. Now peripheral vascular diseasecan present itselfa couple of different ways andthere's a broad spectrum. Patients who smoke,patients who are diabetic, patients who carry all of thetypical cardiac risk factors are
at increased risk forperipheral arterial disease. The thing about peripheralarterial disease though is over time, it has a very,very high risk of death. At 5 years after the diagnosisof peripheral arterial disease, the likelihood of survivalis reduced by 25 percent. That's greater than or equal tocolon cancer, Hodgkin's disease, some other things that peoplepay a lot more attention to. When you get advanced stagesof peripheral arterial disease,
that number goes upprecipitously to the point that you know survivalis of grave concern, not because people die fromperipheral arterial disease but because it affectsthemthe form of stroke and heart attack whichobviously can be fatal. Patients that have this problemoften times complain of fatigue, tiredness or discomfortin their legs. The typical pattern is theycan walk a certain distance,
after which they have to stop because their legs really won'tallow them to go any further. They rest for a few minutes and the blood recirculatesin the legs. They resume their walking and can go a similar distancebefore stopping again. A lot of times this problemis blamed on old age, on immobility, onliving a sedentary life.