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What is important to know for your first appointment for Peripheral Arterial Disease.

Each of you is unique and no two people have the exact same PAD. We can not plug your data into an equation and get a correct plan of treatment.  No specific single risk calculator is appropriate for all patients with PAD.


What may be causing my leg pain?

Though we are specifically evaluating you for peripheral arterial disease, our goal at the end of the evaluation is to have a game plan for the cause of your leg pain.

What are the other possible causes of Leg Pain?

Spinal stenosis or nerve root compression, joint or spinal arthritis, chronic muscle compartment syndrome, venous disease, restless leg syndrome, or a metabolic cause.

What may be the cause of my leg wound?

Lower extremity or leg wounds can be very difficult to diagnose. Our goal, with the assistance of the wound care clinic, is to diagnose and treat the cause, therefore allowing your tissues to heal. 

Possible causes besides arterial disease may be venous disease, autoimmune disease, chronic infection, neuropathy, medication-related, small artery disease/metabolic disease which can include diabetes or smoking, or cancer.

Will the doctor ask about my smoking and tobacco use? 

Tobacco use is the leading preventable cause of disease, disability, and death in the United States. Smoking and smokeless tobacco (e.g., chewing tobacco) use increases the risk of all-cause mortality and is a cause of ASCVD. Secondhand smoke is a cause of ASCVD and stroke, and almost one-third of chronic heart disease deaths are attributable to smoking and exposure to secondhand smoke. Even low levels of smoking increase the risks of acute MI; thus, reducing the number of cigarettes per day does not totally eliminate the risk.


Will the doctor ask to have my blood work checked? 

We will try our hardest not to duplicate bloodwork that is already done by your primary care physician but up-to-date labs are very important.

Diabetes mellitus significantly increases the risk of atherosclerotic disease. We may check bloodwork for: 

  • Hemoglobin A1c level. Abnormal is > 6.5% 
  • Albumin level tells about nutrition and health
  • Kidney function (estimated glomerular filtration rate (eGFR) and creatinine level).

Hypercholesterolemia is a significant risk factor. Your blood may be tested for:

  • Total cholesterol. Abnormal is >200 mg/dl
  • Low-density lipoprotein (LDL) cholesterol. Abnormal is > 160 mg/dl
  • High-density lipoprotein (HDL) cholesterol. < 40 mg/dl for men and < 50 mg/dl for women.
  • Triglycerides. ABNORMAL IS < 40 mg/dl for men and < 50 mg/dl for women.

Will my blood pressure be checked?

Hypertension is a risk of atherosclerotic cardiovascular disease.

Stage 1: BP of 130-139/ 80-89 mmHg

Stage 2: BP of  >140/ >90 mmHg

Will my weight be checked?

Obesity is a risk factor for heart disease. Obesity is a BMI > 30. We will calculate your BMI. Individual weight is not as important for your PAD risk. 

Why is an ultrasound done on my leg? 

An ultrasound can tell us multiple things about the arterial flow in your leg. Just as we check the blood pressure in the arm as a source of your blood pressure in your body, we will take similar blood pressure measurements and compare them to your arms. This will tell us if there is a decreased pressure of flow going down your legs. The ultrasounds can also directly give us evidence of poor flow in areas of the arteries of the legs. 

The ultrasound can tell us the severity of the disease, which next test may be required, or if there is a different cause of your symptoms. Without an ultrasound, the physician is completely blind to what may be causing your discomfort. 

What other tests may be needed?

A Cat Scan (CT) specifically looking at the arteries may be ordered to give a roadmap of what the ultrasound suspects is going on.

An MRI specifically looking at the arteries can also be used for certain patients who can’t undergo a CAT scan.

An angiogram is a procedure in which we use catheters to put dye into specific areas of the artery to give us the roadmap of the anatomy and the disease. Treatment may be possible at the same time. 

Will the vascular surgeon be prescribing any medication?

Anti-platelet medication may be prescribed and the reasoning will be explained. Aspirin and Plavix are examples.

Hypertension, diabetes, and cholesterol medications may be suggested. We will refer you back to your primary care physician for these medications or adjustments in the doses.

Blood thinning (anticoagulation) medications may be prescribed and the reasoning will be explained. Coumadin or warfarin or heparin-type such as Lovenox or examples.

Is surgery always used to treat arterial disease?

No. Peripheral arterial disease affects everyone very differently. The arterial narrowing or blockages will be very unique to each person almost like a fingerprint. The optimal or possible treatment to get blood flow past the diseased segment of the artery may have several options or only one. 

Open surgery has been found to be the gold standard for the treatment of peripheral arterial disease. Minimally invasive endovascular procedures using angioplasty, stents, and other techniques within the artery have been found to be equal to or better in some patients. 

We will evaluate you and then explain the best possible treatments. We will discuss all options and you will choose. 

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality globally. In the United States, it is also the leading cause of death for people of most racial/ethnic groups, with an estimated cost of >$200 billion annually in healthcare services, medications, and lost productivity.

References to the above information: 


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Snake River Vascular Surgery
An Affiliate of Idaho Falls Community Hospital

2330 Desoto Street
Idaho Falls, ID 83404

Phone: 208-528-1098
Fax: 208-528-1960