The Importance of Angiograms for Treating PAD

Too many people with peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.) have a toe, foot or leg amputatedTo have had all or part of a limb (leg, foot or toe) surgically removed. as their first-line treatment. “53% of the people in this country get amputations without getting diagnostic tests taken to see whether or not you can increase the blood supply to the leg,”^5,16 says Dr. Aaron Horne, an interventional cardiologist with HeartCare Specialists in Fort Worth, Texas.

It’s important that you research all possibilities before agreeing to an amputationTo surgically remove all or part of a limb (leg, foot or toe). An angiogram can determine the viability of alternatives to an amputation like lifestyle changes, medical management, supervised exercise therapy or revascularizationThe restoration of the blood circulation to an organ or area, achieved by unblocking obstructed or disrupted blood vessels or by surgically implanting replacements. (including minimally invasiveIn minimally invasive surgery, surgeons use a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows you to recover faster and heal with less pain and scarring. procedures) for successful treatment. With the information provided by an angiogram, you and your doctor can make a more informed health care choice.

What is an angiogram?

Angiogram tests use X-rays to take a series of images of your blood vessels. A physician may use these imaging techniques:

• Magnetic resonance angiography (MRA). A non-invasive type of MRI (magnetic resonance image) that looks specifically at the body’s blood vessels.
• Computed Tomography angiography (CTA). This is another non-invasive test that combines a CT scan with the injection of a dye to create pictures of the blood vessels in the legs.
• Catheter angiography. This minimally invasive procedure involves guiding a catheter through an arteryArteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. in your groin or wrist to the affected area and using X-rays to see how an injected dye flows through your arteriesArteries are blood vessels that carry blood to your heart and other parts of your body..

The importance of angiograms in determining a PAD treatment plan

Knowing the results of an angiogram can allow physicians more treatment options when they know the extent of blockages and how to restore blood flow. A health care provider may recommend lifestyle changes, such as quitting smoking, eating a healthy diet and exercising regularly. Medical therapies such as cholesterol and blood pressure medications may also be prescribed.

“Early detection is extremely helpful to prevent patients from having the worst outcomes,” says Dr. Jihad Mustapha, Associate Professor of Medicine at Michigan State University. “With early detection, you can potentially avoid advanced or end-stage PAD such as critical limb ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (CLI), which usually presents like an ulcerUlcers (or wounds) can occur when there is poor blood flow in your legs or feet. Poor blood flow causes cells to die and damages tissue, often on the feet and legs. These types of wounds can be slow-healing. on the foot or gangreneGangrene is dead tissue, caused by poor blood flow to part of your body. Gangrene can occur on the skin or in muscles or organs. Peripheral artery disease is a known cause of gangrene. on the foot.”

If a medical procedure is necessary, angiograms provide necessary data about the location and severity of the narrowed area of a blood vessel. Based on that information, a treatment plan for revascularization can then be developed.

For more information

“Never agree to an amputation without an angiogram,” says Dr. Mustapha. “An angiogram alone increases your chances of not having an amputation by approximately 90%.”⁵

If you’ve been told you need an amputation, don’t be afraid to get a second opinion. Use CSI’s Find a Doctor tool to help explore the variety of PAD treatment options available.