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How do I know if I have circulatory problems in my legs?
What are the risk factors for peripheral vascular disease?
Should I see a vascular specialist?
How can vascular disease be treated?
What is an angioplasty?
What is bypass surgery?
What can I do?
What are the risks?

How Do I Know if I Have Circulatory Problems in My Legs?
 
When you walk, do you have pain or cramping in your leg muscles that goes away when you rest? After you rest, can you walk exactly the same distance again before the pain stops you and you must rest? If you answered “yes” to these questions, then you may be exhibiting the hallmark symptoms of intermittent claudication. Intermittent claudication is the term used to describe pain in the legs that occurs when you walk. The pain is the result of a decrease in blood flow to the legs. This diminished blood flow is most often the result of atherosclerosis, the term used to describe the buildup of fatty deposits (plaque) on the insides of the arteries.
 


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What are the Risk Factors for Peripheral Vascular Disease?
 
There are several conditions and habits that increase your chance for vascular disease. Fortunately, many of the risk factors are within your control. Risk factors include:
 

Smoking
High blood pressure
High LDL cholesterol
Low HDL (good) cholesterol
Being overweight
Sedentary life-style
Diabetes
Over 50
Being postmenopausal
Family history of atherosclerosis

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Should I See a Vascular Specialist?
 
Do not ignore your leg pain! The severity of the disease and length of time it goes untreated can make a big difference in your treatment and recovery. If you think you may have a problem, make an appointment to see a vascular specialist. Remember, atherosclerosis can occur in any of your arteries. If you are having symptoms in your legs, it is possible that arteries in your heart or neck could also be narrowing, setting you up for a possible heart attack or stroke.

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What Will a Vascular Specialist Do?
 
A thorough medical history and physical exam will give the doctor information needed to determine if further tests are required.
 
Your doctor may order a test, called a Segmental Pressure Check, to check the blood flow in your leg arteries. A vascular technologist will wrap blood pressure cuffs around both arms, and at four places along your leg — the upper thigh, the lower thigh, the upper calf, and the ankle. The technologist measures the blood pressure at each location, and the blood pressures in the arms are compared to those in the legs. A decrease in blood pressure in the legs is an indication of arterial blockage. You may also have an ultrasound scan of your legs.
 
If angioplasty or surgery is being considered as a possible treatment for you, your doctor may recommend an angiogram. During an angiogram, dye is placed in the artery while X-ray pictures are taken. The dye “lights up” your arterial system, making it possible to pinpoint the exact location and severity of your blockages.

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How Can Vascular Disease be Treated?
 
The best treatment will depend on a number of factors. In some cases, life-style changes are enough to slow the progress and manage the disease. Sometimes, procedures are necessary to open up clogged blood vessels.
 
The goal of any treatment program will focus on reducing your number of risk factors and will usually include:
 

Exercise program
Reduction of fat and cholesterol in diet
Controlling diabetes and hypertension
Smoking cessation; if you are a smoker, it is absolutely essential that you stop
 
After your diagnostic testing is completed, your doctor may determine that you will benefit from angioplasty or a bypass procedure to treat your poor circulation.

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What is an Angioplasty?
 
While watching a “live” X-ray, your physician guides a catheter (a hollow tube) to the area of blockage through the femoral artery in your leg. A tiny balloon located at the end of the catheter is inflated to widen the passageway for blood flow. Sometimes a stent (a small mesh tube) is placed inside the artery to hold it open and create a smooth surface within the artery.

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What is Bypass Surgery?
 
Bypass surgery is a way to create a new pathway through which the blood can flow. Either a vein or a synthetic graft is attached to your artery above and below the area of blockage, creating a route around the blockage and improving blood circulation to the legs and feet.

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What Can I Do?
 
You can change your life-style to reduce any unhealthy habits that contribute to peripheral vascular disease. If you smoke, it is very important to stop! Also, you will want to remove fat and salt from your diet, and start a daily exercise program.

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What are the Risks?
 
As with all invasive procedures, there is some risk associated with angioplasty and bypass surgery. Your physician will be able to inform you of any risk specific to your particular case.
 
Remember
It is important to be your own best health advocate. A good way to do that is by committing to routine physical exams and diagnostic tests as often as is recommended by your vascular specialist. Early detection of circulatory problems is the key to effective treatment.

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