Hardening of the Arteries Is a Red Flag for Vascular Disease, Including Heart Attack and Stroke
Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a very common condition affecting 12-20 percent of Americans age 65 and older. PAD develops most commonly as a result of atherosclerosis, or hardening of the arteries, which occurs when cholesterol and scar tissue build up, forming a plaque inside the arteries that narrows and clogs them, leading to a very serious condition. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking, and eventually gangrene and amputation. In the renal arteries (the arteries that feed the kidneys), this can cause high blood pressure and renal insufficiency.
Balloon angioplasty and stenting has generally replaced invasive surgery as the first-line treatment of PAD. Early randomized trials have shown interventional therapy to be as effective as surgery for many arterial occlusions, and in the past five to seven years, a very large clinical experience in centers throughout the world has shown that stenting and angioplasty are preferred as a first-line treatment for more and more processes throughout the body.
The long-term clinical results of stent placement to treat PAD are comparable to those of aortofemoral artery bypass surgery, with a much lower risk of associated morbidity and mortality. Surgery should be reserved for the rare patient in whom stenting cannot be done or fails.