07/31/2018

Consistent cramping in your calf? You may want to be checked for peripheral arterial disease.

Angioplasty is a minimally-invasive treatment option to treat PAD

Have you ever walked a certain distance and felt cramping in your calf? Do you later walk a shorter distance and feel that same cramping?

Dr. Kristy Wiebke
Dr. Kristy Wiebke, vascular surgeon with St. Joseph’s/Candler – Vascular Specialists

If you experience consistent cramping in your calf, you may have a blockage in a peripheral artery.

“Claudication, which is pain in the calf when you walk, is very consistent. It happens every time you walk a certain distance,” explains Dr. Kristy Wiebke, vascular surgeon with St. Joseph’s/Candler – Vascular Specialists. “It begins when the pain doesn’t start until they are a half mile into a walk and then it’s a quarter of a mile and then it’s one block.”

The peripheral arteries carry blood to your lower body and legs. Peripheral arterial disease (PAD) occurs when plaque builds up in the walls of the peripheral arteries, narrowing those arteries and therefore reducing or blocking the flow of blood to your limbs. PAD is most common in the legs but there also are peripheral arteries in the stomach and arms.

PAD affects about 8.5 million Americans, according to the American Heart Association. The risk of PAD dramatically increases with age. If you are over 70 or if you are over 50 and have cardiovascular risk factors such as high blood pressure or diabetes, or smoke, you may be more susceptible to PAD.

PAD symptoms include:

  • Claudication, or pain in the calf when you walk
  • Burning sensation in the feet
  • Sores or wounds on toes, feet or legs that heal slowly, poorly or not at all
  • Color changes in the skin of the feet, including paleness or blueness
  • Poor nail growth and decreased hair growth on toes and legs

The good news is PAD is easily diagnosed in a simple and painless way. If caught early, PAD can be managed with lifestyle changes, including diet and exercise, and medication.

“Patients who have consistent cramping pain in their calves should see a vascular surgeon,” says Dr. Wiebke. “There are things that we can do and medications that we can give patients to try to prevent surgery.”

Angioplasty

If medications and lifestyle changes do not work, or if symptoms are ignored, minimally-invasive treatment may be needed.

Peripheral angioplasty is a procedure that helps open blockages in the peripheral arteries. Angioplasty allows your blood flow to flow better, preventing severe leg pain and cramping and, in extreme cases, amputation.

Angioplasty is typically an outpatient procedure, Dr. Wiebke says. Patients will need to arrange transportation following treatment and not eat or drink anything after midnight the night before the procedure.

The procedure begins with sedation (typically through IV) to make sure patients are comfortable. The insertion site also is injected to numb the area. A tiny incision is made in the groin and a catheter is inserted into the blood vessel. Following an injection of a contrast dye for imaging, a tiny balloon is pushed through the catheter to the blockage. The balloon is inflated and deflated a few times to compress the plaque, opening the blocked artery and restoring blood flow. The balloon and catheter are then removed.

Additional courses of treatment also may be performed during an angioplasty.

Some patients may require a stent placed in the blocked area. A stent is a small metal or mesh tube. It is sometimes used to help keep your artery open. The stent fits over the balloon and the balloon and stent then slide through the catheter to the blockage. The balloon is inflated, pressing the stent against the artery wall. The balloon is removed and the stent stays in place to help keep the artery open.

Another technique used during an angioplasty is drug-coated balloons. Medication lines the outside of the balloon and is absorbed by the blood vessel walls to decrease the risk of recurrence, Dr. Wiebke explains.

Some patients may require an atherectomy, which is a technique that shaves off some of the calcium lining the artery. This makes the artery more compliant to an angioplasty, Dr. Wiebke says.

“There are multiple options from an endovascular standpoint,” Dr. Wiebke says. “These advances in technology have decreased the number of patients that need bypass surgery or end up with major amputations.”

If you have any signs of PAD, especially consistent cramping in the calf, talk to your doctor or visit a vascular surgeon. A referral may be required, depending on your insurance.

For more information about Dr. Wiebke and St. Joseph’s/Candler – Vascular Specialists, call 912-354-8331 or visit our website.

  • St. Joseph's Hospital Campus: 11705 Mercy Blvd., Savannah, GA 31419, (p) 912-819-4100
  • Candler Hospital Campus: 5353 Reynolds St., Savannah, GA 31405, (p) 912-819-6000
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St.Joseph's Hospital Campus: 912-819-4100

Candler Hospital Campus: 912-819-6000