This patient came in with tired, heavy legs, due to decreased circulation because of plaque build-up in her Saphenous Femoral Artery. A short walk was nearly unbearable because of the immediate pain. A quick procedure allowed this grandmother of 5 to leave the office with immediate relief, and a hope that she could enjoy playing with her grandchildren again.

Calcifications like these, when left untreated, may lead to an increased risk of Peripheral Artery Disease. With this procedure, patients can be on their way home, 2 hours after surgery, with immediate relief from these agonizing symptoms!

In the early stages of PAD, issues with skin on the legs will be one of the first symptoms to show. As those issues progress because of poor circulation, a common ailment is that inflamed skin opens up to wounds, and those wounds won’t heal.

Why won’t the wounds heal if you have PAD? PAD is caused by poor circulation in the legs, and poor circulation inhibits oxygen from adequately reaching the extremities, like your legs and feet. Poor circulation is also the cause of your skin feeling cold to the touch—there’s not enough blood getting to that part of your body.

If blood is not circulating properly and if oxygen isn’t reaching your legs and feet to your open wounds, that’s where our problem is. Wounds require oxygen to heal properly. Poor circulation can prevent open wounds from ever healing, and that leaves your body more vulnerable to infection.

If you have open wounds on your legs or feet, or if you have diabetic foot sores, please book a free consultation today!

There are several symptoms that are associated with PAD, one of those being changes in the skin on your legs. But how do you know what to look for?

With PAD, the legs already have poor circulation, so skin changes are simply evidence of that poor circulation. In the beginning, the compromised circulation can cause the skin to become leathery, itchy, red skin is common. Additional problems can occur as well, such as sores and ulcers.

In the early stages of PAD, toenail growth may slow down significantly, and your skin may become more dry and itchy. This is when you may notice that your skin feels cool to the touch. As progression occurs, leg hair may stop growing completely, your skin may become thicker, shinier, and have a red or purple tint, and they may swell more often. After an increase in swelling, wounds may appear, and not completely heal, leading to those open ulcerations. 

If you’ve noticed any or multiple of these changes in the skin on your legs, please book a consultation today. We would love to help you!

In a short answer, no. The more complicated answer? Kind-of. Totally confused? Let’s walk through this. 

PAD in itself is not a genetic disease. Studies have been conducted to see if there are specific genetic markers that can lead to PAD, but so far, nothing definite has been found. However, there are some hereditary risk factors that may lead to the development of PAD.

Risk factors for PAD include:

• Diabetes
• Tobacco Use
• High Blood Pressure
• High Cholesterol
• Obesity
• Increasing age (after 50)

Because of poor circulation that comes along with diabetes and smoking, people with those two risk factors are at a higher risk for developing PAD. 

If you know you have a family history of any of the risk factors for developing PAD, you can take steps to help prevent it. If you smoke, quit smoking. If you’re a diabetic, monitor your blood sugar closely, and do your best to keep it under control. Exercise regularly—it doesn’t have to be intense, but get to moving if it’s okay with your doctor. Lower your cholesterol and blood pressure, and be more mindful of eating foods that are high in saturated fats. Weight control also helps to reduce the risk of PAD. 

Symptoms of PAD:

• Hip or leg cramps after walking or climbing stairs
• Leg numbness or weakness
• A cold feeling in a lower leg or foot, more so than in the other foot
• Sores that won’t heal
• A change in the color of your legs
• Hair loss/slower hair growth on your legs
• Slower growth of your toenails
• Shiny skin on your legs
• No pulse/weak pulse in your legs/feet
• In men—erectile dysfunction

If you have any or multiple symptoms of PAD, come see us. We would love to help you!

After reading the last article, I looked more into chronic venous insufficiency. While browsing online, I read an article that claims venous insufficiency symptoms can actually predict thrombosis for the elderly. Is this true? I’m concerned since my aunt is exhibiting symptoms and is also elderly.
–Tim from Killen

It is true that some symptoms of Chronic Venous Insufficiency (CVI) can be indicators of a more serious problem – specifically venous thrombosis, which is a blood clot that forms within the veins.

Varicose veins (also known as “spider veins”), leg ulcers, leg edema, and reduced blood flow are common symptoms of CVI which can also double as risk factors of venous thrombosis. This condition usually occurs in people who are 70 years or older; in fact, 60% of cases occur in this demographic.

According to a study performed concurrently in the U.S. and in the Netherlands, researchers found that venous thrombosis could develop either with or without pulmonary embolism, which is a sudden blockage in a lung artery that is usually caused by a blood clot that forms in the leg and travels through the bloodstream to the lung.

In the study, venous thrombosis occurred in patients with varicose veins 1.6-fold, in patients with leg ulcers 3.3-fold, and in patients with leg edema 3-fold. Researchers also found that the highest risk for thrombosis occurred when patients exhibited all three of these symptoms simultaneously. Venous thrombosis alone developed in 41% of patients, and pulmonary embolism with or without thrombosis developed in 59% of patients.

Since Chronic Venous Insufficiency is a major indicator of venous thrombosis, it is important to identify any cases of CVI as soon as possible. So what are some telltale signs of CVI?

Signs of Chronic Venous Insufficiency

CVI is associated with varicose veins and commonly develops in people who stand or sit for long periods of time. Some symptoms of CVI include:

• Swelling in the legs and feet at night (which decreases by morning)
• Thickened toenails
• Hair loss on the feet
• Aching or heaviness in the legs
• Itching, tickling, or swelling
• Cramping in the legs at night or while resting
• Reduced pain in the morning or while standing
• Skin color changes around the ankles
• The appearance of “spider veins”

CVI occurs when the walls and/or the valves in the leg veins are not working effectively, making it difficult for blood to return to the heart. This condition causes blood to “pool” or collect in the veins. People who experience CVI often complain that long car trips are difficult since the heaviness, cramping, and swelling in their feet is painful.

The main way to diagnose CVI is to undergo a Doppler venous evaluation with a cardiovascular specialist. A cardiovascular specialist can also recommend compression stockings or perform laser ablation to treat this condition.

If you want more information regarding CVI or venous thrombosis, call the Cardiovascular Institute of the Shoals at 256-766-2310 to schedule an appointment.

For the past couple of years, I’ve been experiencing pain in my legs – specifically swelling and throbbing – every time I walk. My legs cramp and burn frequently. They feel heavy and restless for no reason, and because of the swelling and cramping, I can’t take long car trips anymore. I’ve also noticed that I’ve lost hair on my feet and my toenails seem thicker. Sometimes my feet even change to a reddish or white color. No one seems to know what the problem is or why my legs hurt so much. The only thing that helps is when I rest my leg in an inclined position. What’s causing my leg pain, and what can be done to help my pain go away?
–Kathy from Florence
There are many possible reasons for the leg pain you are currently experiencing.

Chronic Venous Insufficiency

For example, based on the symptoms you’ve outlined, you may be experiencing CVI, or Chronic Venous Insufficiency. CVI occurs when the walls and/or the valves in the leg veins are not working effectively, making it difficult for blood to return to the heart. This condition causes blood to “pool” or collect in your veins, which causes swelling like what you have described.

CVI is associated with varicose veins and commonly develops in people who stand or sit for long periods of time. Some symptoms of CVI are:

• Aching or heaviness in the legs
• Itching, tickling, or swelling
• Cramping in the legs at night or while resting
• Reduced pain in the morning or while standing
• Skin color changes around the ankles
• The appearance of “spider veins”

To evaluate CVI, your doctor should recommend a Doppler venous evaluation. To treat CVI, your doctor may suggest the use of compression stockings, which decrease swelling and other symptoms. A cardiovascular specialist can also perform laser ablation to treat CVI.

Arterial Insufficiency

Another possible reason for your leg pain is arterial insufficiency. Arterial insufficiency usually indicates arterial claudication, which results from a lack of blood supply to the muscles.

Some of the symptoms associated with arterial insufficiency include:

• Leg pain while walking
• Calf muscles tightening and cramping while walking
• Redness in the feet while feet are hanging down
• Whiteness in the feet while feet are elevated
• Thickened toenails
• Loss of hair on the feet

Changing position does not usually help with symptoms; in fact, the only thing that often helps is stopping any current activity. As the lack of blood supply gets higher in the leg toward the abdomen, pain while walking may also occur in the buttock muscles.

This is another condition that requires a Doppler evaluation. If a significant blockage is found, then you may also need further arteriographic studies at a cardiac catheterization lab.

Venous Claudication

Another possible condition you may have is venous claudication, which occurs when the leg feels pain, or even freezes, during exercise. If you have venous claudication, you may have a blood flow restriction in the deep venous system, which may develop because of blood clots or post deep venous thrombosis (DVT) scarring. DVT occurs when a blood clot forms in one or more of the deep veins in your body, usually in your legs.

If you’re experiencing this condition, you may also feel chronic edema (or swelling). With venous claudication, elevating the legs should reduce chronic edema and pain. In order to determine if you are suffering from this condition, you should undergo a venous duplex imaging study. Treatment for this condition includes using graded compression stockings and receiving laser ablation treatment for the insufficient veins.

Cellulitis

If you experience a sudden onset of painful red swelling of the lower extremities, accompanied by itching and a swollen leg, you may have cellulitis – otherwise known as a skin infection. This is typically treated with antibiotics and elevating the leg usually helps. However, this could be a sign of acute venous insufficiency as well.

If you experience any of these symptoms, you should have your leg evaluated with Doppler venous ultrasound.

Spinal Claudication

Lastly, another potential reason for leg pain may be spinal claudication. If you are experiencing this condition, you may feel pain in the buttocks and hips when you walk. Spinal claudication may hurt worse with activity but may go away when you rest and when you bend over. The change in posture and the discontinuation of activity decreases pain.

If you believe you may have any of these conditions and want to learn more, call the Cardiovascular Institute of the Shoals at 256-766-2310 to schedule an appointment.