Leg blockages should not be ignored: Peripheral Artery Disease, or Vaso-Occlusive Disease

By Ashton Daigle

While cramping of the calves might merely be signs of overexertion of the muscle, prolonged and continued cramping could also be a sign of something more severe - leg artery blockage.

“It’s one of those things that people typically just blow off, ” Dr. Nephtali Kogan, selected as a Chicago Top Doctor by TopTierMD as a top rated cardiovascular specialist in Chicago, said. “I’ve heard of cases where the patient practically can’t even walk any more. It’s definitely something you shouldn’t ignore.”

In most cases, Dr. Kogan said, the discomfort begins with tightness in the calf while walking. The discomfort usually increases from there. Dr. Kogan said the condition can occur in both legs, with symptoms often getting worse over time. Dr. Kogan says some patients only complain of weakness in the legs when walking, however, or a feeling of tiredness.

“Eventually, it gets so severe that we see complete blockages start to develop,” Dr. Kogan said. “It can get to the point where the patient develops lesions on the feet that don’t heal.”

If an artery is almost completely blocked, pain may occur even when a person is resting. The pain may feel like pins and needles or severe burning and is often worse at night. Very severe cases, Dr. Kogan said, can also lead to gangrene, which, in turn, can make amputation necessary.

Peripheral artery disease, or vaso-occlusive disease of the legs, is the cause of these blockages. The peripheral arteries carry blood to tissues other than those of the brain, heart and lungs. Peripheral arterial disease damages tissues by depriving them of blood, which carries oxygen and nutrients to the tissues. The damaged tissues may die if blood flow is not improved.

The condition may occur for many reasons, including smoking, diabetes and high cholesterol. Dr. Kogan said that blockages of leg arteries can happen to anyone, but that the condition is particularly common in smokers and in elderly people.

In some cases, leg blockages can also result from sudden, complete blockage by part of a blood clot that formed in the heart, aorta or another artery. In those cases, part of the clot can break off and travel through the bloodstream, becoming an embolus, until it reaches an artery that is too small for it to pass through. In these cases, excruciating pain can occur suddenly and usually requires emergency surgery.

Specialists use a variety of different ways to assess blood supply to the legs. One way is to check the pulse or blood pressure in the legs. If arteries are extensively blocked, the pulse can be decreased or absent.  Doppler ultrasonography can also be used to measure blood flow and to help determine the extent of the blockage.

The goal of treatment, Dr. Kogan said, is to prevent blockages from worsening by opening arteries.

“In the past, we used to do it surgically, pretty much like bypass surgery,” Dr. Kogan said. “But with that method, you get a very long recovery time and a greater chance of more complications.”  Now, Dr. Kogan said, doctors use balloons similar to the ones used in coronary angioplasties for the procedure.

“We’ve found that the use of balloons greatly reduces the risks commonly associated with surgeries,” Dr. Kogan said.

Dr. Nephtali Kogan, MD, was selected by TopTierMD as a Chicago Top Doctor and is considered Best in cardiovascular disease in Chicago. He specializes in coronary artery disease evaluation and catheter-based treatment, peripheral vascular disease evaluation and catheter-based treatment, and coronary stenting and angioplasty.