Leg Pain and PVD
By Michael Lasalandra
Beth Israel Deaconess Medical Center Correspondent
Robert Reddington was getting himself in shape last winter for his daily four-mile walk on the beach by walking up and down the corridor of his condo in Florida. He figured that once he worked himself up to doing 16 laps, he would be ready for the sand.
But one day, just before he had reached the 16th lap, the 83-year-old retired telephone company worker from Needham couldn’t go any further.
“I got an excruciating pain in my leg and I couldn’t go on,” he says. “It was like a sharp jab in the calf. It was so painful.”
When he stopped walking, the pain went away, but it would return as soon as he began walking again. “I couldn’t go a quarter mile,” he says.
Reddington, who has had two stents inserted into coronary arteries that were cleared with angioplasty procedures, had no idea what was going on in his left leg. “I thought maybe I was low on potassium,” he says.
During a visit to his doctor in Florida for another problem, he mentioned the leg pain. Tests revealed he was suffering from peripheral vascular disease, a term that refers to blockages in arteries or blood vessels that don’t feed the heart. Most often, these involve arteries in the lower extremities.
When Reddington returned to Massachusetts after the winter, his family doctor referred him to Dr. Allen Hamdan, a vascular and endovascular surgeon at The Cardiovascular Institute at Beth Israel Deaconess Medical Center.
Dr. Hamdan performed a minimally invasive procedure -- similar to a coronary artery angioplasty -- to clear the blockage in the leg artery. A stent -- a wire mesh tube -- was also inserted to keep the artery open.
Usually, Dr. Hamdan says, patients are given the option to try and manage the condition with medications and lifestyle changes. But Reddington says he didn’t want to take the time. “I’m 83 and I didn’t want to wait,” he says.
If angioplasty doesn’t work, bypass surgery is the final option.
According to Dr. Hamdan, such peripheral blockages can occur in the legs, neck or abdominal arteries. They are caused by cholesterol, diabetes or smoking -- or any combination of these factors. Most with PVD don’t develop symptoms. But for a signifcant minority, treatment of one sort or the other is needed. In some cases, the condition can lead to the development of leg ulcers or even gangrene.
Dr. Hamdan says PVD is becoming better known thanks to informational campaigns being sponsored by the Society for Vascular Surgery and the American Heart Association. The idea is to make people aware of the condition and seek help.
“These leg symptoms need to be evaluated,” he says. “There are minimally invasive treatments available that are successful.”
In Reddington’s case, the angioplasty worked just fine.
“I was out of the hospital and walking at home the next day,” he says. “Everything went fine. I’m up to three miles now.”
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2009
