Vascular Surgeon Shares Scoop on PAD

Posted: February 9, 2017

Peripheral Arterial Disease (PAD) and other disorders of the vascular system were the focus of an interesting discussion during the Feb. 8 #OurDocTalk with vascular surgeon Brandi Upton, M.D.

#OurDocTalk is a live Facebook chat in which interested followers who visit NorthBay’s Facebook page (Facebook.com/NorthBayHealthcare) post their questions and comments and a NorthBay doctor replies.

Dr. Upton spent much of the chat explaining PAD and its diagnosis and treatment.

“Blockages can occur in the legs just like in the heart or the arteries of the neck going to the brain,” she explained in one post. “Blockages in the arteries of the legs can cause pain when you walk. If the blockage gets very advanced, it can cause ulcers on the feet or pain at all times.”

When asked about detecting blockages if a person has no symptoms, Dr. Upton said there are options.

“There are some screening tests that are non-invasive and can be done in our clinic,” she noted, adding “I typically do not recommend treatment unless you are having symptoms for arterial blockages in the legs.”

Waiting for symptoms “seems too late,” noted one Facebook follower.

“There are some simple screening exams that can be done here in our office to look for PAD, most commonly a test to compare the blood pressure in the arms vs. the legs,” Dr. Upton assured.

Dr. Upton also fielded a question on treatments for varicose veins.

“One of the first treatments for varicose veins is compression stockings. But there are newer procedures that can help,” she noted. “If a patient is found to have reflux in the veins (meaning the valves are not working properly), then radiofrequency ablation can be a good procedure to improve wound healing and help with the varicose veins as well.”

The chat can still be viewed on the NorthBay Facebook page at Facebook.com/NorthBayHealthcare.

Here is an edited transcript of the chat:

Q.: Is there a cure for ANCA-negative vasculitis?

Dr. Upton: I typically will be involved in the complication associated with the disease not the initial treatment. I typically have those patients seen by Rheumatology.

Q.: Are there tests that can be done regarding blockages if you aren't having symptoms?

Dr. Upton: Yes there are some screening tests that are noninvasive and can be done in our clinic. However, I typically do not recommend treatment unless you are having symptoms for arterial blockages in the legs

Q.: That effect legs also?

Dr. Upton: Yes blockages can occur in the legs just like in the heart or the arteries of the neck going to the brain. Blockages in the arteries of the legs can cause pain when you walk. If the blockage gets very advanced, it can cause ulcers on the feet or pain at all times

Q.: With a family history of PAD what is the best way to monitor or know symptoms early? Seems too late once you have any symptoms.

Dr. Upton: There are some simple screening exams that can be done here in our office to look for PAD, most commonly a test to compare the blood pressure in the arms vs the legs.

Q.: If someone has a 5cm aneurism of the the ascending aorta. What is the activity restrictions? What is the best treatment?

Dr. Upton: Ascending aortic aneurysms are treated and monitored by cardiac surgeons but typically are treated once the size gets near 6cm or the patient is having symptoms.

Q.:  What is the best way to treat severe vericose veins? What do you recommend for treating ulcers around the ankles?

Dr. Upton: One of the first treatments for varicose veins is compression stockings. But there are newer procedures that can help. If a patient is found to have reflux in the veins (meaning the valves are not working properly), then radiofrequency ablation can be a good procedure to improve wound healing and help with the varicose veins as well

Response: NorthBay Healthcare thank you!

Q.: Can diabetic neuropathy be reversed?

Dr. Upton: Unfortunately, no. There are some medications that can help relieve symptoms but not necessarily reverse it

Q.: I'm actually a Kaiser patient, but was wondering if you knew anything about pelvic AVM'S and the use of ethanol embolization treatments?

Dr. Upton: Unfortunately, I do not have any experience with pelvic AVMs. In my experience, interventional radiologists are more training in this.

 

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