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Johns Hopkins Medicine Vascular Surgeon Dr. Thomas Reifsnyder discusses symptoms, diagnosis and treatment of severe peripheral arterial disease (PAD). He also shares insight on how to avoid limb amputations, including leg and foot removal.
Rapidly expanding endovascular techniques including angioplasty and stenting are an attractive option for selected patients with severe PAD involving the upper (subclavian arteries) and lower extremities, renal (kidney) arteries and carotid arteries. Angioplasty and stenting is a catheterization procedure similar to a cardiac catheterization only the arteries of interest are in another vascular territory. This involves a tiny puncture of usually an artery in the groin followed by x-ray guided catheter-based balloon dilation in an area of severe blockage typically followed by stenting which is catheter-based placement of metal mesh expandable cylindrical scaffolding (called a “stent”) that keeps the diseased artery open to its normal size when angioplasty alone cannot dilate the artery sufficiently or in certain locations where stents works better than angioplasty alone. With this rapidly expanding technology, many patients with PAD can now can be treated with a procedure that is much less invasive and less risky than standard surgical procedures with similar outcomes and a shorter recovery times (usually involves a one night hospitalization).