Sandra Pangratz has always lived a very healthy lifestyle. The 73-year-old walked three miles every day near her home outside of Iron River, and ate a healthy diet. A vascular condition was the last thing she thought would keep her from being active.
But that’s exactly what happened.
In February 2012, part way into her daily walk, she began experiencing pain and cramping in her right leg. She was referred to the physician team at the Marquette General Heart & Vascular Institute.
These top-ranked cardiologists, cardiothoracic surgeons and other medical staff provide a comprehensive range of care from cardiac stress tests, to bypass surgery to vein care and surgery.
After reviewing tests, Dr. Bill Jean, an interventional cardiologist, determined that despite her healthy lifestyle, Sandra had Peripheral Artery Disease (PAD), and she would need a trans-catheter procedure on her right leg.
PAD is a common circulatory problem in which plaque builds up inside the arteries and obstructs blood flow to the lower limbs and feet. PAD is one of the most common cardiovascular diseases, affecting 5 – 12 million Americans.
Factors that increase your risk of developing PAD include: smoking, diabetes, obesity (body mass index over 30), high blood pressure, high cholesterol, family history of PAD, heart disease or stroke, being 50 years of age and older.
Patients who develop PAD usually notice hip, leg or calf pain when walking (claudication). As PAD advances, it can cause severe foot or toe pain when stationary. More severe symptoms, such as skin changes on the feet or legs, may be a sign of advanced PAD.
In many cases, when caught early enough, the first step in treating PAD is exercise, a healthy diet and quitting tobacco usage. But for people like Sandra who already have a healthy lifestyle, a trans-catheter procedure was the first step.
Several procedures were required to reopen Sandra’s arteries to allow proper blood flow to her right leg: balloon angioplasty, stenting and atherectomy.
With angioplasty, the blocked artery is widened with a medical “balloon.” The balloon presses against the inside wall of the artery to open it and improve blood flow. To prevent the artery from narrowing again, a tiny metal stent is placed across the artery wall.
Sandra then received a drug-coated (drug eluting) stent – the first patient in the Upper Peninsula to receive this breakthrough treatment for PAD. This metal mesh stent, which was previously just used in coronary arteries, contains a drug that helps prevent recurrent narrowing of the arteries in the thigh.
“Sandra couldn’t walk and was experiencing pain even while resting so we had to restore blood flow to the foot,” Dr. Jean said. “Below the stent site there were blockages in the more distal, smaller vessels. An atherectomy procedure was used in this area, as these are too small for stents.”
Next was an atherectomy which is a procedure that utilizes a catheter with a sharp blade on the end to remove plaque from a blood vessel.
“Today we have a variety of treatment options for PAD patients,” said Dr. Jean. “It wasn’t too long ago that amputation was the norm. Now we’re able to save limbs and we have the technology to do that right here in the U.P.”
An atherectomy is especially helpful for treating blockages in arteries that occur around branches or in vessels that are not easily treated with stents. In Sandra’s case, the procedure was successful and she was soon back to daily walking and fitness.
Unfortunately, Sandra soon began to experience familiar symptoms, this time in her left leg. A return visit to Dr. Jean verified that she did, in fact, have PAD in the left leg.
“This occurrence is quite common in both legs with PAD patients,” Dr. Jean explained.
Sandra is confident, positive and determined to return to her active lifestyle after her circulation is restored.
Many people experience mild symptoms or no symptoms at all and therefore don’t report it to their physicians. Because PAD often goes undetected and if untreated can lead to heart attack and stroke, screenings are recommended for the following: those over the age of 70; those over 50 with a history of diabetes or stroke; those under 50 with diabetes, PAD risk factors like obesity or high blood pressure.
For Sandra, it was her healthy walking habit that allowed her to detect an issue with her legs. If you have leg pain, numbness or other symptoms, don’t dismiss them as a normal part of aging. Make an appointment with your doctor.