Do you feel pain or aching in your legs, especially in the groin area, when you walk? Does this pain increase when you walk a little distance and decrease when you stand still? If you have these symptoms, you may also be affected by this condition. Don't worry, this is a condition that affects many people. Today, let's talk about what causes this and a modern treatment method called Atherectomy.
What is PAD? Why do veins get clogged?
Simply put, PAD stands for Peripheral Artery Disease . In Sinhala, it is a blockage of the blood vessels (arteries) that carry blood to distant organs such as the limbs of our body. Imagine that over time, things like rust and dirt get stuck in a water pipe. In the same way, "plaque" can be deposited inside our blood vessels. This plaque is a layer formed by the accumulation of things like cholesterol, fat, and calcium. In medicine, we call this (Atherosclerosis) .
As the blood vessel gradually narrows due to this blockage, the amount of blood that passes through it decreases. When you exercise or walk, the muscles in your legs need more blood, which means more oxygen. But because the veins are blocked, they don't get the amount of blood they need. That's when the pain and numbness come.
What is the treatment called atherectomy?
Atherectomy is a special treatment that removes or cleans out the plaque that has built up inside a blocked blood vessel. This is not a major surgery. It involves inserting a very thin tube (catheter) through one of your blood vessels and guiding it to the blockage. At the end of this tube is a very thin, sharp blade or a device that emits laser light.
To be precise, this is like putting a wire inside a clogged pipe and scraping out the dirt inside.
This device cuts and scrapes away the hardened plaque. Sometimes, this treatment may involve a balloon angioplasty to further open the artery or a stent to prevent it from closing again. Your doctor will explain this to you in detail.
How many types of atherectomy are there?
Yes, doctors use different atherectomy techniques depending on the nature and location of the blockage in the blood vessel. There are several main types.
| Atherectomy type | Simply put, what happens |
|---|---|
| Excisional Atherectomy | The yellow layer is removed by cutting it to one side with a sharp blade. |
| Laser Ablation Atherectomy | Laser beams are used to dissolve, vaporize, and destroy the yellow layer. |
| Orbital Atherectomy | The yellow layer is scraped off with a rapidly rotating device, similar to sandpaper. |
| Rotational Atherectomy | A device with many small blades is rotated in a circle to crush and remove the yellow layer. |
What should I do before this treatment?
Before you undergo this treatment, your doctor will order several tests to see exactly how blocked your blood vessels are.
- Angiography: A test in which a special dye is injected into the veins and an X-ray is taken to create a map of the veins.
- Vascular Ultrasound: A scan that uses sound waves to look at the flow of blood inside the veins and to detect blockages.
The day before your treatment, you will receive some special instructions.
- It's time to stop eating and drinking.
- About taking or stopping medications you are taking, especially anticoagulants .
It is very important to follow all of these exactly as your doctor advises.
What happens during treatment?
When you go to the hospital, you will be given a special gown to wear. Then, you will be given medicine to numb you so you don't feel any pain during the treatment. This is often done while you are still conscious, but with a mild sedation.
1. The doctor will make a small hole in a blood vessel in your groin or arm and insert a thin tube (catheter) through it.
2. Then, while looking at an X-ray screen, the tube is carefully guided to the location of the blocked vein.
3. Once you reach the blockage, activate the device (blade or laser) at the end of the tube and scrape or cut away the yellow layer.
4. This process can be repeated several times until there is no obstruction to blood flow.
Usually, this entire process takes about two hours.
What to expect after treatment?
After the treatment, you will need to lie flat in bed for several hours (probably about 6 hours) to prevent bleeding from the catheter insertion site. During this time, the nurses will be constantly checking your blood pressure and pulse.
In most cases, this is a treatment that allows you to go home the same day without having to stay in the hospital. However, some people may have to stay in the hospital for a day. It depends on your condition. You will be able to resume normal activities in a few days. However, it is best to ask your doctor for advice.
What are the advantages of this?
The main advantage of atherectomy is that it can be performed through a small incision, rather than a major surgery . This results in shorter recovery time, less pain, and less scarring.
Are there any side effects or risks?
As with any medical treatment, there may be some risks.
- When you scrape the yellow layer, a small piece of it can break off and get stuck in another small vein in front of you.
- Very rarely, the scraping device may damage the vein wall, causing a scratch or a hole.
But these don't happen very often. Experienced doctors take every step necessary to minimize these risks.
When do you want to see the doctor again?
When you go home after treatment, you should call your doctor right away if you develop any new symptoms or if any of your existing symptoms get worse. Be especially careful about the following:
- Severe pain in the groin or treated leg.
- Leg swelling (edema) .
- Redness or a feeling of warmth in the treated area.
- Feeling cold or numb in the treated leg.
If you feel something like this, don't ignore it. Seek medical advice immediately.
Take-Home Message
- PAD (Peripheral Artery Disease) is a condition in which the blood vessels in the limbs become narrowed and blocked. This can cause pain in the legs when walking.
- Atherectomy is a modern treatment method that removes blocked arteries using a thin tube, without major surgery.
- This treatment is generally safe and the recovery time is short.
- It is very important to strictly follow the doctor's instructions before and after treatment.
- If you experience any unusual symptoms (pain, swelling, bruising) after treatment, inform your doctor immediately.
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