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Peripheral Arterial Disease

Peripheral arterial disease, also known as PAD, is a condition that affects your circulatory system causing blockages in your blood vessels. PAD affects nearly 8 million people older than age 40, and up to 20 percent of those people are older than 65 years. Although not difficult to diagnose, as many as 90 percent of people who have PAD remain un- or under-diagnosed.

The Peripheral Arterial Disease section of the Heart Institute at Stony Brook Medicine takes a comprehensive approach to your care. Led by Allen Jeremias, MD, we offer innovative diagnostic and treatment options that can help determine whether or not you have PAD and the best treatment approach to take. As proud as we are of our technology, we take even more pride in seeing that your well-being comes first.

Our highly skilled team of physicians, board certified in interventional cardiology, vascular medicine or both, takes a collaborative, multidisciplinary approach to your care. We stress open communication and will fully discuss your diagnosis and treatment options with you and your family. We also work closely with your other physicians to ensure you receive the best care possible.


What is it?

PAD is a partial or complete blockage of an artery or arteries that supplies oxygen-rich blood to organs and tissues throughout your body. When this blockage reduces blood flow to the tissues in the limbs or organs, you may experience symptoms.

There are different types of PAD. The most common occurs in the legs and is known as lower extremity disease. Other types of PAD affect blood flow to the arms (upper extremity disease), or kidneys (renal artery disease). Symptoms do not usually appear early in the disease process because the body builds its own bypass, or detour, around a narrowed artery with smaller blood vessels. Eventually, however, these new vessels are unable to keep up with the tissues' needs for oxygenated blood and symptoms may start. The most common symptom for PAD, especially in the legs, is pain when walking. This pain may be originally a general discomfort or mild discomfort or cramp, and may occur at first only when you walk prolonged distances or up-hill. As PAD becomes worse, you may feel this pain with walking shorter distances or even at rest.

If you have high blood pressure or high cholesterol, you are at greater risk for PAD. Smokers and people with diabetes have an especially high risk of developing PAD.

You can control PAD by changing your lifestyle. Eating a healthy diet, getting adequate exercise, controlling your blood pressure, and lowering your cholesterol can be especially helpful at reducing your risk or alleviating symptoms. Most important, if you are a smoker . . . quit smoking.

At Stony Brook Medicine, our goal is to treat PAD initially without any invasive techniques. For example, you may be instructed to exercise and modify other lifestyle behaviors or may be prescribed medication. We work closely with you to avoid surgery, and if these early techniques do not improve your PAD, we will usually first suggest minimally invasive procedures. Minimally invasive procedures are a preferred method of treatment because you typically experience less pain, any incisions are generally very small, you have less blood loss, and you usually recover more quickly. If you are not a candidate for a minimally invasive procedure or your PAD requires more invasive methods of treatment, we will work closely with one of our vascular surgeons to plan a treatment method.


Services

Our specialists will work with you to diagnose your PAD and tailor an appropriate treatment approach for your unique situation. To diagnose PAD, we offer noninvasive tests such as:

  • Evaluation of the peripheral circulation by segmental blood pressure for assessment of the lower extremities
  • Ultrasound
  • Computed tomography (CT) angiography
  • Magnetic resonance (MR) angiography


When noninvasive treatments do not sufficiently treat your PAD, we offer minimally invasive procedures such as:

  • Atherectomy, which removes the plaque, cholesterol, and fibrous tissues that block arteries by cutting or shaving the blockage inside the artery. Click here to watch a video of this procedure.
  • Excimer laser, a type of atherectomy, uses lasers inside your artery to vaporize the blockage.
  • Angioplasty, in which a physician advances a special small balloon through catheters (thin, flexible tubes inserted into your arteries) to the location of the blockage. The balloon is then inflated to open up the blockage.
  • Stenting, during which the physician implants an expandable stainless steel metal coil in a narrowed vessel to keep it open.


If surgery is required, our specialists will collaborate with vascular surgeons at Stony Brook to see that you receive the most appropriate care available.


The Stony Brook Difference

We make your overall care, comfort, and well-being our top priority. Our specialists in peripheral arterial disease at Stony Brook Medicine are dedicated to diagnosing and treating your PAD using the most innovative and least invasive diagnostic and treatment methods available.

With physicians board certified in interventional cardiology and vascular medicine, you are seeing some of the most experienced and highly skilled specialists in the region. Our multidisciplinary approach means that you are treated by specialists trained in areas important to patients with PAD, ensuring that you receive the best care available.

Stony Brook Medicine treats PAD at two conveniently located clinics, where you receive your care on an outpatient basis. Our tests and procedures are performed at Stony Brook Medicine.

As a leader in the study of peripheral arterial disease, Stony Brook Medicine participates in numerous national research trials. Participation in clinical trials helps us evaluate new treatments, drugs, or devices, and find innovative and improved ways to provide you with exceptional care.


Our Team

At Stony Brook Medicine, the specialists in our Peripheral Arterial Disease section focuses on your treatment and comfort. We work collaboratively with each other, your referring physician, and — most importantly — you to develop the best treatment plan for you. We stress a continuum of care as well as care coordination with your cardiologists and primary care physician. Our team offers decades of training and experience, insight from cutting-edge research, state-of-the-art facilities, and a patient-focused environment to provide you with superior outcomes and a positive patient experience.


Allen Jeremias, MD

Allen Jeremias, MD

Anil Mani, MD

Anil Mani, MD


The Stony Brook Heart Institute - Peripheral Arterial Disease

Contact:
Stony Brook Medicine
Nicolls Road and Health Sciences Drive intersection
Stony Brook, NY, 11794

Phone: (631) 44-Heart


Learn More

Click here to watch a video of the Atherectomy procedure.