Transforming peripheral arterial disease treatment improves patient outcomes

Peripheral Arterial Disease (PAD) is condition resulting in narrowing of the arteries to the legs and arms that affects millions of people worldwide, yet it remains underdiagnosed and misunderstood by many. At Loma Linda University International Heart Institute, a specialized PAD program is changing lives by providing comprehensive care and innovative treatments, helping patients avoid severe outcomes like amputations.

PAD occurs when arteries in the legs become narrowed or blocked due to atherosclerosis – a buildup of fatty deposits, or plaques, that reduce blood flow. "When you think of a cardiologist, many think our focus is on the heart. But atherosclerosis is a systemic process," says Vinoy Prasad, MD, FACC, FSCAI, director of interventional cardiology. "It doesn't just affect the heart's arteries; it affects arteries through the body."

Patients with PAD often experience symptoms such as claudication, which is pain or cramping in the legs due to inadequate blood flow or non-healing wounds. In severe cases, the condition can lead to gangrene and necessitate amputation. However, traditional treatments have mainly focused on surgery or aggressive medications that can have significant side effects and require long recovery periods.

Amr Mohsen, MD, co-director of the structural heart program, highlights a significant alternative to these invasive methods. "The treatment of vascular disease, when blood vessels are tight or occluded, is not always surgery. We can use wire balloons, stents, and very small equipment, which we do daily at the International Heart Institute."

The PAD program leverages advanced endovascular techniques and minimally invasive procedures that do not require open surgery. Physicians can access blocked arteries using small catheters, clear them, and insert stents to restore blood flow. This approach allows for same-day discharge for most patients, minimal recovery time, and significantly reduced risks compared to traditional surgery.

"This procedure is done with a tool like an IV and does not involve any blades, knives, or sutures," Mohsen says. "Ninety percent of these patients go home the same day." This method has proven to be highly successful, particularly for patients who might otherwise face limb amputation due to severe arterial blockages.

I could hardly lift my right leg, and walking my dog became daunting. I had to put on my pants while sitting down because standing was just too difficult Ambrose Romero, 71

The 71-year-old came to Loma Linda University Health with severe claudication, which made walking nearly impossible. He underwent various treatments, including vein procedures and being put on blood thinners after a clot was dislodged during an unrelated procedure.

Romero experienced two embolisms in his lungs, which led to a prolonged hospital stay and a significant reduction in his mobility. His frustration grew as he struggled to walk even halfway around his block without needing to stop and rest.

Romero regained mobility and reclaimed his lifestyle after a simple, same-day procedure. "I'm back to better than I was five years ago, and I'm enjoying every moment," he says.

Through Romero's groin, Prasad performed iliac stenting, a minimally invasive procedure that involves inserting a small wire mesh tube, called a stent, into a narrowed iliac artery or vein to keep it open.

"I walked without any issues immediately after the procedure. I even purposefully parked far away so I could test how well I could get around," Romero says. "I recently completed an eight-and-a-half-mile hike, something I hadn't been able to do for years. Before, I had to slow down at every incline, but this time, I breezed through it."

The program at Loma Linda University Health stands out for its advanced techniques, compassionate care, and commitment to patient education and advocacy. Patients who might have once faced dire outcomes now have hope for a better quality of life.

"We are not just putting stents in; we are also treating the patient holistically, reducing all of their risks, treating their lipids, managing diabetes, hypertension, and other conditions that contribute to the progression of atherosclerosis," Prasad says. "Our goal is to identify these patients early, start them on aggressive medical therapy, and when necessary, perform minimally invasive procedures to improve their quality of life."

For individuals diagnosed with PAD or those experiencing symptoms such as leg pain or non-healing wounds, consulting with a specialized team like that at Loma Linda University Health can provide valuable options. Early detection and treatment are vital in preventing complications.

"If any patient is told that they have a severe vascular disease that cannot be fixed or that they need open surgery, they need a second opinion," Mohsen says. "There is a good possibility they have other minimally invasive options because this is not available in a lot of centers."

Loma Linda University International Heart Institute care teams are committed to providing patients with compassionate, comprehensive, and personalized cardiovascular care. To learn more, please visit Peripheral Arterial and Venous Disease or call 1-800-468-5432 to make an appointment.