In the previous blog, I described PAD as a common symptom presenting as a leg problem. I also alluded to the concept of risk factor awareness and possible modification. But before we get there, we need to understand how this occurs in the first place. I say to my patients, “This is not complicated, it’s just plumbing.” The arteries are the highways of the body. Their role is to 
transport blood (containing oxygen and nutrients) from place to place. If they get restricted or clogged, then that part of the body that was supposed to get the nutrients doesn’t, and bad things happen as a result. Essentially, PAD describes the clogging or narrowing of the arteries as a result of plaque formation.
Almost everyone has heard the term plaque, but not everyone necessarily understands what it means. There is plaque on your teeth, and plaque in your arteries, but what is it? For lack of a better word, plaque is simply an accumulation of debris inside the arteries. The mechanism of plaque formation and the complexities involving this are beyond the scope of this blog. But suffice it to say that the underlying mechanism driving coronary artery disease is similar to that in the legs, neck, abdomen, etc. It is a global problem not isolated to specific locations in the body. And although it can occur everywhere, it has a tendency to occur in specific locations, causing specific problems. With that in mind, let’s go back to the plaque.
If plaque is basically debris, what is it made of? Plaque is mostly composed of fats and cholesterol along with other blood components. As those accumulations are deposited, they cause a variety of problems. They can restrict the flow of blood in the arteries, causing symptoms to occur. They can also rupture, spewing debris into the arteries. This can have either local effects or remote effects – you’ll learn more on this later when I talk about carotid disease.
Back to risk factor awareness, and more importantly, risk factor modification: we can’t do anything about the hereditary factors we are born with, but we can do something about the other factors that contribute to plaque formation. If we can impact the plaque, we may be able to reduce the problems of both restriction and rupture. All risk factor strategies aim at controlling plaque. In upcoming articles, I’ll examine these one at a time.
Vascular Surgeon Brad Sweda, M.D., is dedicated to the diagnosis and treatment of disorders of the circulatory system, including the arteries and veins. His passion for vascular surgery goes beyond treating an ailment, but rather treating the individual. He sees each of his patients as unique, each requiring their own personalized treatment and attention. Dr. Sweda sees patients in Midland and Alpena. To make an appointment, contact his office at (989) 794-5240.
