Fairfax Radiological Consultants

To Schedule an Appointment Call:
703.698.4488

Peripheral Artery Disease (PAD) and Amputation Prevention

What is PAD and what causes it?

Peripheral Artery Disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs.  It is typically a result of aging and numerous risk factors that result in the build-up of plaque inside the lining of your blood vessels that results in them becoming narrow.

Peripheral Artery Disease (PAD) is caused by a build-up of plaque (fatty deposits and cholesterol) on the walls of the arteries which is called atherosclerosis. Arteries can become so narrow over time that the blood flow bringing oxygen to the muscles, organs and tissue is restricted. If plaque breaks off and gets into the bloodstream, clots can form, causing further problems. PAD is considered a risk factor for heart attack and stroke.  

What are the symptoms?

PAD is typically asymptomatic. If the narrowing becomes bad enough, one can have difficulty walking—resulting in significant cramping pain that improves after resting.  This can limit a person’s ability to exercise or in some cases ability to work.  In more severe cases, it can also result in wounds (ulcers) that do not heal. These are typically in the feet, and less commonly in hands.

While PAD is known for affecting the blood vessels to the legs, it can affect nearly any artery in the body, including the abdomen, brain, kidneys or pelvis. 

Risk factors for PAD include:

  • Diabetes Mellitus
  • Coronary artery disease 
  • Family history of high blood pressure and high cholesterol levels
  • Lack of exercise and sedentary lifestyle
  • Family history of heart or vascular disease
  • Overweight (body mass index over 30)
  • Smoking
  • Over 70 years old (or over 50 if you also smoke and/or have diabetes)

How is PAD diagnosed?

A medical history and physical exam will be conducted by your interventional radiologist. 

Tests may include:

  • Taking a sample of your blood to check for diabetes by measuring your cholesterol and triglycerides.
  • Checking the pulse in your feet and perform a non-invasive test called ankle-brachial pressure index (ABI). It compares the blood pressure in your ankle to blood pressure in your arm.
  • Based on test results, your interventional radiologist may recommend an ultrasound to evaluate blood flow.
  • In specific circumstances, an MRI (magnetic resonance imaging) or CT angiography using a contrasting dye may help identify the extent of narrowing in your blood vessels due to atherosclerosis.

What is limb salvage?

Limb salvage refers to medical care performed to give patients the best possible chance to avoid amputation that has resulted from severe PAD.

Wounds that are a result of peripheral arterial disease with additional risk factors such as diabetes and kidney disease may not heal spontaneously.  A non-healing wound can be at risk for infection, with the biggest concern being infection extending to the bone. 

In these cases the risk of minor and major amputations increases.  A team effort is required to successfully treat these wounds, this includes a foot and ankle doctor, an interventional radiologist and a vascular surgeon. 

Limb salvage centers are dedicated to saving limbs and preserving quality of life. We often receive second and third opinion requests and are proud to offer the expertise to treat the most challenging cases.

pad01 Age 60-69 4.7% Age 70+ 14.5% Up to 5 Millon People in the US Have PAD pad02 SMOKERS ARE 4.5x More Likely to Develop PAD Than The Average Person pad03 DIABETICS ARE 2.5x More Likely to Develop PAD Than The Average Person

PAD is very severe if left undiagnosed and untreated.

pad04 AMPUTATIONS ARE PERFORMED EACH YEAR 100,000 pad05 WOUNDS DEVELOP IN OF PEOPLE WITH SEVERE PAD 10% pad06 4x INCREASED OF AMPUTATION DIABETICS HAVE NEARLY pad07 RISK OF DEATH AFTER FIRST YEAR OF AMPUTATION IS 15-20% pad08 RISK OF DEATH AFTER FIVE YEARS OF AMPUTATION CAN BE AS HIGH AS 60% pad09 RISK OF DEATH FROM CLI (SEVERE PAD) OVER 5 YEARS IS Deadlier than most cancers >50%

Treatment of mild peripheral arterial disease:

Typically, conservative treatment including lifestyle modification and medications are most often the first treatments for PAD. Your interventional radiologist will have an in-depth discussion regarding methods of treatment during your clinic visit.

Treatment of severe peripheral arterial disease:

The presence of a non-healing wound is known as Critical Limb Ischemia (CLI).  Wounds can appear as areas of open sore, skin infection, ulcers that don’t heal or even development of discoloration of the skin (gangrene).  These scenarios are typically more urgent.  During consultation your interventional radiologist will discuss options in treatment of the blood vessel disease as well as managing the wound.

While amputations are a valid life-saving treatment—they should be utilized sparingly. There are many amputations performed yearly without appropriate diagnostic or interventional work up.  If your limb is at risk or an amputation has been recommended, seek out a second or even third opinion and request evaluation for an angiogram.  A team approach between wound care and your vascular specialist is the key to success.

Why Choose Fairfax Vascular Center?

Over 100 years of combined clinical experience.

Fairfax Vascular Center is one of the largest, long-established interventional radiology practices with more than 100 years of combined clinical experience.

Specialize in Peripheral Artery Disease (PAD) and Amputation Prevention.

Our highly trained and experienced radiology subspecialists have helped thousands of patients with PAD and limb salvage in a comprehensive team approach.

Dedicated to helping you through your treatment journey.

Our physicians are available 24/7 to ensure you are well taken care of from the time of consultation through your treatment and follow up.

State of the art imaging with subspecialty trained physicians.

Fairfax Vascular Center is part of Fairfax Radiology Centers, the largest and oldest diagnostic radiology group in the metro DC and surrounding region, allowing us to provide our patients with leading edge imaging technologies and the most experienced diagnostic and interventional radiologists with subspecialty training.

Team approach to care.

We firmly believe that multidisciplinary care is in the best interest of our patients and closely partner with our podiatry, wound care and vascular surgery teams to make sure that your care is in the best hands and you gain the best possible outcome.  

Our Physicians

Paul Reha Butros, M.D.

Paul Reha Butros, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
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Paul Reha Butros, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
Medical School

Baskent University School of Medicine
Completed 2005

Residency

Detroit Medical Center - Wayne State University
Completed 2012

Fellowship

Massachusetts General Hospital/Harvard Medical School
Completed 2014

Miami Cardiac and Vascular Institute
Completed 2015

Board Certification

American Board of Radiology - Diplomate
2012

Professional Affiliations & Memberships

American College of Radiology
American Medical Association
American Roentgen Ray Society
Medical Society of Virginia
Radiology Society of North America
Society of Interventional Radiology

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Alain T. Drooz, M.D.

Alain T. Drooz, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Alain T. Drooz, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of North Carolina

Residency

New York University Medical Center
Completed 1988

Fellowship

New York University Medical Center
Body Imaging
Completed 1989

New York University Medical Center
Interventional Radiology
Completed 1990

Board Certification

American Board of Radiology
1989

Professional Affiliations & Memberships

American College of Radiology
Radiological Society of North America
Society of Cardiovascular and Interventional Radiology
Society of Vascular Medicine and Biology - Fellow
Fairfax County Medical Society

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Aaron R. DuCoffe, M.D.

Aaron R. DuCoffe, M.D.

Joined Practice:
Body Imaging
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Aaron R. DuCoffe, M.D.

Joined Practice:
Body Imaging
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

Emory University School of Medicine 
Completed 2013

Residency

University of Florida College of Medicine
Orthopaedic Surgery
Completed 2014

Georgetown University Medical Center
Diagnostic Radiology
Completed 2019

Fellowship

United States Department of Health and Human Services 
Healthcare Policy/Quality - Opioid Safety
Completed 2015

Emory University School of Medicine 
Vascular & Interventional Radiology
Completed 2020

Board Certification

American Board of Radiology 
Board Eligible 2021
Completed 2018

Professional Affiliations & Memberships

Radiology Society of North America
Society of Interventional Radiology 
American College of Radiology
Reviewer for Pain Medicine
National Ski Patrol

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Michael G. Karnaze, M.D.

Michael G. Karnaze, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Michael G. Karnaze, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Kansas School of Medicine
Completed 1982

Residency

Mallinckrodt Institute of Radiology
Completed 1987

Fellowship

Alexandria Hospital
Interventional Radiology
Completed 1988

Board Certification

American Board of Radiology
Diagnostic Radiology 1987
Interventional Radiology 1995

Professional Affiliations & Memberships

Society of Cardiovascular and Interventional Radiology
Chesapeake Interventional Radiology Society (President 1996)
American Heart Association
American College of Radiology
Radiology Society of North America
American Roentgen Ray Society

Accolades

Top Doctor 
Washingtonian Magazine
Northern Virginia Magazine

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Hong Lim, M.D.

Hong Lim, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Hong Lim, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Medicine & Dentistry
Completed 2001

Residency

University of Medicine & Dentistry
Completed 2006

Fellowship

Baptist Cardiac and Vascular Institute
Completed 2008

Board Certification

American Board of Radiology
2006

Professional Affiliations & Memberships

Radiological Society of North America
American College of Radiology
Society of Interventional Radiology

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David J. Spinosa, M.D.

David J. Spinosa, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

David J. Spinosa, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

Tufts University School of Medicine
Completed 1984

Residency

Georgetown University Hospital
Radiology
Completed 1992

New England Deaconess Hospital
Surgery
Completed 1987

Fellowship

University of Virginia
Angiography and Interventional Radiology
Completed 1993

Board Certification

American Board of Radiology
Radiology - 1992
Angiography and Interventional Radiology - 1995

Professional Affiliations & Memberships

Society of Interventional Radiologists
American College of Radiology

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Mustafa M. Syed, D.O.

Mustafa M. Syed, D.O.

Joined Practice:
Diagnostic Radiology
Vascular & Interventional Radiology
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Mustafa M. Syed, D.O.

Joined Practice:
Diagnostic Radiology
Vascular & Interventional Radiology
Medical School

New York College of Osteopathic Medicine

Completed 2011

Residency

Mount Sinai West Hospital Center 

Completed 2016

Fellowship

Mount Sinai Hospital, Vascular and Interventional Radiology

Completed 2017

Board Certification

American Board of Radiology, 2017

Professional Affiliations & Memberships

Radiological Society of North America

American College of Radiology

American Board of Radiology

Society of Interventional Radiology

 

 

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Jay D. Varma, M.D.

Jay D. Varma, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Jay D. Varma, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Maryland
Completed 1996

Residency

Boston University Medical Center
Completed 2001

Fellowship

Harvard Medical School
Completed 2002

Board Certification

American Board of Radiology
Radiology - 2001
Interventional Radiology - 2003

Professional Affiliations & Memberships

Cardiovascular and Interventional Society of Europe
Chesapeake Interventional Radiology Society 
Medical Society of the District of Columbia
Society of Interventional Radiology
American Roentgen Ray Society
Radiological Society of North America

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Available at the following location

Fairfax Radiology Vascular Center

Fairfax Radiology Vascular Center

8505 Arlington Boulevard
Suite 400
Fairfax, VA 22031
United States

Tel
703.698.4475
Fax
703.573.4237

Request a Telephone Consultation

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If you need an immediate appointment, please call 703.698.4475.