The Importance of Angiograms for Treating PAD

Too many people with peripheral artery disease (PAD) have a toe, foot or leg amputated 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 amputation. An angiogram can determine the viability of alternatives to an amputation like lifestyle changes, medical management, supervised exercise therapy or revascularization (including minimally invasive 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 artery in your groin or wrist to the affected area and using X-rays to see how an injected dye flows through your arteries.

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 ischemia (CLI), which usually presents like an ulcer on the foot or 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.