HONOLULU (KHON2) — Peripheral Artery Disease is a common condition that causes leg pain and weakness. The disease is a narrowing or blockage in the legs and it is most often a chronic condition.

“So, it happens over a period of years to decades. It’s usually caused by disease or plaque. And it most commonly affects people with diabetes, chronic kidney disease or smoking. It’s quite common here in Hawaii,” said Dr. Tanner Kim, vascular surgeon at The Queen’s Medical Center-West Oahu.

Symptoms cover a wide spectrum and mostly involve the legs.

“Some may notice that one leg is cooler than the other, or both are cool. The most common symptoms I hear from my patients are leg cramping or discomfort with walking. They often tell me they can walk a certain distance before they get the onset of this pain. The more severe cases, they might have really bad pain in their feet, especially at night,” Dr. Kim said.

“It’s actually due to gravity, so when they have really bad disease, during the day the gravity helps pull the blood flow down. But for most people, when they sleep, they lie flat at night. So, they lose the effect of gravity, and that’s when they really feel a lot more at nighttime.”

Dr. Kim added that when it comes to treatment, it is important to step back and look at atherosclerosis as a whole because it affects other parts of the body, including the heart.

“We want to be sure that we address all this, make sure they’re on the right medications as well as doing important lifestyle changes like stopping smoking. Firstly, for most of my patients, I recommend that they do some sort of exercise. If conservative treatment doesn’t work well, then we’ll start thinking about surgery,” Kim said.

There are two forms of surgery. The first is endovascular procedures and the second is open surgery.

“Endovascular procedure is a minimally invasive option where we use wires and catheters to try to cross the blockage and then open it up with either a balloon or a stent. For more severe disease, we do open surgery where we either clean out the vessels or do a bypass around the diseased segment,” said Dr. Kim.

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