Peripheral Artery Disease

The surgical team at Bay Surgical Specialists has extensive experience helping patients with peripheral arterial disease.

What is peripheral arterial disease? 

Peripheral artery disease is a common circulatory condition where arteries have narrowed and reduced the blood flow to the extremities. Peripheral artery disease can be caused by many factors, and patients may be asymptomatic, or the symptoms may range from mild discomfort to severe, debilitating pain. 

Arterial narrowing can happen in any artery in the body.  Atherosclerosis is one of the most common causes for peripheral arterial disease.  Atherosclerosis is the fatty deposits (plaque) that accumulates (“builds up”) on the interior of the artery walls.  Blood vessel inflammation, injuries, anatomy, and exposure can also cause peripheral artery narrowing. 

There are many risks involved with peripheral arterial disease, such as increased risk of infection, tissue death, even amputation, stroke and heart attack.

Peripheral Artery Disease Treatment

Treatment for peripheral arterial disease can be as easy as a lifestyle change, such as stopping smoking, or as complicated as requiring surgical intervention and on-going wound care management.

Minimally-Invasive Endovascular Treatment of Peripheral Arterial Disease: Angioplasty, Stenting

When an artery becomes too narrow to function, surgeons can try to open a narrowing or blockage with minimally-invasive procedures like an angioplasty or stenting.   

Angioplasty:  Our skilled vascular surgeons will insert a catheter (a small tube) into an artery and guide the catheter to the narrowed area(s).  There is a balloon on the end of the catheter which the surgeon will inflate.  Inflating the balloon does two things; it stretches the artery to reopen it and it flattens the blockage to further open the artery. 

Stents:  Sometimes during an angioplasty procedure, a surgeon will determine that a device should be implanted to hold the artery open.  The device is called a stent.  A stent is a mesh tube that allows blood to flow through its interior.  Many people associate stents with heart procedures, but they can be used in other parts of the body, too.

Angioplasties and stents are an in-patient procedure that requires a short hospital stay, typically 12-24 hours after the procedure is completed.  Our surgical team can review the procedure during a surgical consultation.

Lower Extremity Bypass/Peripheral Arterial Bypass

When blood flow is blocked significantly and an angioplasty and/or stent may not be enough, a surgeon may need to perform a peripheral artery bypass.  This procedure involves removing a small portion of artery and replacing it with a medical tube or grafting a vein from another part of the patient’s body. The goal is to re-route blood around the blocked area and restore blood flow past the blockage.  An arteriogram x-ray may be taken to ensure the graft is functioning as expected.

Depending on where the blockage is will determine how a patient will be sedated during the procedure and the recovery time.

Treatment of Arterial Leg and Foot Ulcers

Poor circulation can be a factor why infections and open sores (aka ulcers) won’t heal.  Patients with diabetes are commonly at risk for these complications, but anyone suffering from atherosclerosis can develop arterial ulcers.  Arterial ulcers are often quite painful and antibiotics may not be enough to cure them.  Restoring proper blood flow and removing the infection may need to be done surgically to help the ulcer heal. 

It may be determined that an angioplasty, stent, or arterial bypass is necessary to unblock a narrowed spot in the artery above the infection.  Having oxygen-rich, antibody-rich blood pumping to the infected area will be vital to healing the area.  If there is extensive tissue damage preventing the ulcer from healing, the surgeon may need to remove affected tissue and insert a drainage tube to reduce swelling.

Proper wound care follow-up will be necessary to ensure the ulcer is reducing in size and that the correct medicine and care instructions are being administered.  Debridement of the ulcer area can be an important way to encourage new tissue and remove dead or infected tissue.

Lower Extremity Amputation

Unfortunately, a person may be faced with a reason to amputate a toe, foot, or portion of the leg.  Injuries, infections, anatomical reasons, and many disorders may cause irreparable conditions that require surgical intervention.  Our medical team understands that a patient facing amputation needs compassion and a supportive care plan to return to their daily living.  Our team of board-certified surgeons will help to assess the amputation level and use their expertise to carefully perform the surgery.

An amputation level describes where is body part is amputated and plays a role in obtaining the correct prosthesis. 

Foot amputation – A foot amputation can range from a portion of a toe to midfoot to the area below the ankle.

Transtibial amputation- This would be an amputation of the lower leg, from below the knee joint.

Knee disarticulation – This type of surgical amputation happens above the knee with the thigh left intact.

Transfemoral amputation – When an amputation requires part of the thigh is removed, a transfemoral amputation is performed.

Hip distarculation – When an amputation requires the hip joint be removed, it is called a hip distarculation.

Hemipelvectomy- When an amputation requires an entire leg and part of the pelvis to be removed, this is called a hemipelvectomy

Our team can walk patients through their pre-, during, and post-operative experience and provide guidance and reassurance throughout that time.