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Symptoms Symptoms include foot pain that does not go away, Claudication (leg cramping or pain with walking), lack of warmth in the lower leg or feet. Diagnosis The ankle-brachial index test is a non-invasive approach to identifying the presence of PAD. A comparison is made between the blood pressure in the patient's arms and feet. If the ankle pressure is significantly less, then further testing may be required to evaluate the severity of the disease. Other tests include the use of radiological exams
Treatment Many patients with PAD can be treated conservatively with cholesterol lowering medications, aspirin and other medical therapies designed to decrease claudication. It is important for primary care physicians to know that the vast majority of patients with PAD who require an intervention can now be treated with an ever-expanding and improving array of endovascular approaches that substantially reduce patient ' s pain and morbidity. However, PAD in the femoral and popliteal arteries tends to be quite extensive, leading to poor patency with most of the older endovascular techniques (such as PTA) used to re-open blocked vessels.
In fact, the patency of this technique rivals femoro-popliteal bypass with substantially lower morbidity. Dr. Saxon was the principal investigator, who led the team in analyzing the Multi-center data for femoropopliteal stent-grafting that led the FDA to approve this technique in June, 2005. Moreover, Patients treated by these physicians at the San Diego Cardiac and Vascular Institute have had excellent and durable results unsurpassed on the West Coast. As a result of this expertise in the field of PAD, the interventionalists were selected with 10 other centers of excellence to begin a new pivotal study on drug-coated stents for PAD. This trial is the first in the U.S. to test whether Paclitaxol drug-eluting stents have benefits in treating arteries outside the heart. Drug-eluting stents that combine a metal scaffold with a drug were first applied in the heart and the results have been outstanding. Currently, drug-eluting stents are the primary therapy for obstructions in the coronary circulation as they markedly reduce restenosis or re-narrowing of the artery. It is hoped similar technology, used in the legs, will help those who suffer from peripheral arterial disease. By participating in this trial, the interventionalists at North County Radiology are bringing this potentially landmark treatment to patients in Southern California much earlier than would otherwise be possible. We are currently the leading enrollment site in the county on this trial and the only center in Southern California selected to participate. Drs. Gooding, Ponec and Saxon perform these cutting-edge procedures at Tri-City Medical Center in Oceanside . The interventionists are experts in the diagnosis, work-up and treatment of PAD and are always available for consultation, office visits and treatment 24 hours a day. If you, or someone you know, would benefit from a consultation regarding the treatment of PAD and would like to be considered for these cutting-edge treatments for PAD, please contact our Clinical Coordinator, Jeanine Coffman, RN at 760-940-7166.
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