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Vital Signs

Spring 2004

Treatments for Vascular Disease Ease Pain, Save Limbs

“As more people survive heart attacks and strokes, we are seeing a significant increase in circulatory problems of the lower extremities. The ‘vascular’ component of ‘cardiovascular’ disease is becoming more evident,” notes Peter Lawrence, M.D., director

Peripheral vascular disease —a narrowing of vessels that carry blood to leg and arm muscles—can result in conditions ranging from pain and cramps to non-healing wounds. People with diabetes are particularly at risk for peripheral vascular disease, but the elderly, smokers and those with high blood pressure are also at risk.

The least severe circulatory problems can be treated with a combination of diet, exercise and medications. Some medications prevent blood clotting, others make the oxygen-carrying red blood cells more flexible in order to ease through blockages. “Currently, a number of clinical trials with angiogenesis drugs are underway; these drugs increase blood flow by growing new blood vessels,” Dr. Lawrence explains.

When poor circulation causes extreme pain and cramping, minimally invasive devices help clear clogged and narrowed arteries. “Just like an angioplasty of the heart, we can use catheters to deliver balloons and stents to open blocked arteries. Using simple diagnostic tests including ultrasound and blood flow devices, we can often pinpoint the blockage to within an inch,” Dr. Lawrence notes. “Blockages that cause leg cramps can actually be in the calf, behind the knee, thigh, femoral region, or even in the abdomen.”

In the past, advanced circulatory problems may have required limb amputation. “With a combination of new wound care therapies, hyperbaric oxygen, and surgical approaches, we can increase blood supply and save people’s limbs,” he says. “Nowadays, virtually every vascular disease patient is a candidate for some sort of circulation-saving procedure.”

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