Erin Shaw FNP-BC Phlebologist at our Fort Wayne Clinic
Is there a test to help diagnose and treat PAD?
Yes, PAD is diagnosed by a procedure called Ankle/Brachial Index .This is an ultrasound test which compares the systolic pressure of the upper and lower limbs. Treatment will include lifestyle changes, medications and sometimes surgery and is usually successful in improving and managing symptoms. Notify your family doctor regarding any questions about PAD symptoms.
So what happens if you are found to have PAD, you receive
treatment but you still notice problems with your legs?
First and foremost, remain persistent in your follow-up with the physician treating you. Often these symptoms can be a result of a progression of the PAD or other conditions which should be evaluated. Your physician can guide you through this process. One of the conditions which can cause similar symptoms is venous insufficiency. Venous insufficiency is the failure of the veins to effectively return the blood to the heart and lungs. This happens because the veins have developed incompetent valves or, in some cases, the valves are absent. As a result, the blood and fluid begins to pool in the feet and legs causing cramping, fatigue, heaviness, restlessness, itching, burning, aching and pain.
What are the symptoms of venous insufficiency?
Often with venous insufficiency, your legs may look normal but you could see spider veins, bulging veins, changes in the color and texture of your skin and swelling. This normally begins in middle age but can occur as early as teenage years. Causes are considered familial and it is aggravated by multiple life factors. The list of factors includes hormone changes associated with puberty, pregnancy and aging, long periods of sitting, long periods of standing, trauma or deep vein blood clots.
Did you know Decatur Vein Clinic offers free consultations?
How do you diagnose venous insufficiency?
The most common test used to determine if you have venous
insufficiency is also a duplex ultrasound or mapping. The ultrasound in this case
- This is the ultrasound machine we use during the mapping procedure. During the mapping, we find the exact location of the patient’s diseased vein(s).
evaluates the valve function of the veins and measures the size of the veins in
the superficial venous system. The superficial system is typically where this
condition begins and remains limited to. Typically the deep venous system will
also be evaluated to determine valve competence or if deep vein blood clots are present. Treatment will again include lifestyle changes, conservative treatment and medical treatment which will successfully improve and manage symptoms.
What is conservative treatment for venous insufficiency?
Conservative treatment of venous insufficiency includes regular exercise, elevation of the feet and legs, weight management, avoiding tight-fitting clothing, changing your position often, gradient compression stocking (preferably professionally fitted) and the use of anti-inflammatory medication. This is a chronic condition and cannot be cured, so lifestyle changes and continued use of conservative treatment is imperative.
How do you treat venous insufficiency?
Medical treatment of venous insufficiency consists of a variety of minimally invasive procedures that are very effective. The most common procedures used today are an Endovenous Laser Treatment, Ultrasound Guided Sclerotherapy and Ambulatory Phlebectomy. Choice of the type of procedure for you would depend on many factors. The vein specialist treating you would discuss what is most appropriate for you.
The most important take home message is: don’t wait, you don’t have to be miserable. Talk to your physician, get evaluated, use conservative treatment and lifestyle changes as instructed and get treatment.
You will feel better and the progression of PAD and venous insufficiency will be
PAD artery Image http://www.vdf.org/community/pad.php
PAD Information http://www.vdf.org/diseaseinfo/pad/
Ankle-Brachial Index test http://www.webmd.com/heart-disease/ankle-brachial-index-
Venous image http://www.ask.com/wiki/Antivaricosest
Griffin’s 5 Minute Clinical Consult, Lippincott, Williams
and Wilkins, 2005, Mark R. Dambro.
Pathophysiology: The Biologic Basis for Disease in Adults
and Children, Mosby, 1994, Kathryn L. McCance and Sue E Huether.
Clinical Guidelines in Family Practice, Barmarrae, 1998,
Constance R Uphold and Mary Virginia Graham.
Sclerotherapy: Treatment of Varicose and Telangiectatic Leg
Veins, Mosby, 2001, Mitchel P Goldman and John J Bergan.
Erin Shaw’s article on PAD “Questions & Answers on diagnosing and treating PAD” is part three of our four-part series on PAD.