How is peripheral artery disease (PAD) treated?
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Johns Hopkins Medicine answered:Select patients with severe peripheral artery disease (PAD) can take advantage of rapidly expanding endovascular techniques including angioplasty and stenting.
Both are attractive options for patients who have severe PAD involving the upper (subclavian arteries) and lower extremities, renal (kidney) arteries, and carotid arteries. With angioplasty and stenting, patients with PAD can now be treated with procedures that are less invasive and less risky than standard surgical outcomes. Patients usually experience similar outcomes and a shorter recovery time; usually one that involves an overnight stay at the hospital.
Select patients with severe peripheral artery disease (PAD) can take advantage of rapidly expanding endovascular techniques including angioplasty and stenting. Both are attractive options for patients who have severe PAD involving the upper... More -
American Heart Association answered:Most people with PAD can be treated with lifestyle changes, medicines or both. Lifestyle changes to lower your risk include:
- stop smoking (smokers are 2 to 25 times more likely to get PAD and experience symptoms of PAD 10 years earlier than nonsmokers.)
- control diabetes
- control blood pressure
- be physically active (including a supervised exercise program)
- eat a low-saturated-fat, low-cholesterol diet
PAD may require drug treatment, including:
- medicines to help improve walking distance
- antiplatelet agents to keep the platelets from sticking together and triggering a blood clot
- cholesterol-lowering agents (statins)
Lifestyle modifications (including an exercise program) usually improve symptoms or keep them from getting worse. In a minority of patients, lifestyle changes alone aren’t sufficient. Then angioplasty or surgery may be needed.
If a long part of an artery is narrowed, surgery may be needed. A vein from another part of the body or a synthetic blood vessel is attached above and below the blocked area to detour blood around the blocked spot.Most people with PAD can be treated with lifestyle changes, medicines or both. Lifestyle changes to lower your risk include: - stop smoking (smokers are 2 to 25 times more likely to get PAD and experience symptoms of PAD 10 years earlier than... More -
NewYork-Presbyterian Hospital answered:There are a variety of new endovascular treatments for peripheral arterial disease affecting circulation to the legs. These include a range of techniques from angioplasty and stent placement to atherectomy and other new techniques that are rapidly evolving in the field.There are a variety of new endovascular treatments for peripheral arterial disease affecting circulation to the legs. These include a range of techniques from angioplasty and stent placement to atherectomy and other new techniques that are rapidly... More -
Dr. David Marmor of NorthShore University HealthSystem answered:First and foremost, treat the risk factors for atherosclerosis. People with peripheral artery disease (PAD) are at substantially higher risk of heart attacks and stroke, so you need to be very aggressively treated to control cholesterol and blood pressure. You will also be given antiplatelet medicines. There are medications that are effective for reducing PAD symptoms, but probably the most effective intervention for symptoms improvement is a supervised exercise program. If symptoms are severe or life threatening (such as leg gangrene), we get more aggressive about revascularizing blood vessels through angioplasty or lower extremity bypass surgery.First and foremost, treat the risk factors for atherosclerosis. People with peripheral artery disease (PAD) are at substantially higher risk of heart attacks and stroke, so you need to be very aggressively treated to control cholesterol and... More -
American Diabetes Association answered:People with peripheral arterial disease (PAD) are at very high risk for heart attacks and stroke, so it is very important to manage cardiovascular risk factors. Here are some steps you can take:
- Quit smoking. Your health care provider can help you.
- Aim for an A1C below 7%. The A1C test measures your average blood glucose (sugar) over the past 2 to 3 months.
- Lower your blood pressure to less than 130/80 mmHg.
- Get your LDL cholesterol below 100 mg/dl.
Studies have found that exercise, such as walking, can be used both to treat PAD and to prevent it. Medications may help relieve symptoms.
In some cases, surgical procedures are used to treat PAD:
- Angioplasty, also called balloon angioplasty: a procedure in which a small tube with a balloon attached is inserted and threaded into an artery; then the balloon is inflated, opening the narrowed artery. A wire tube, called a stent, may be left in place to help keep the artery open.
- Artery bypass graft: a procedure in which a blood vessel is taken from another part of the body and is attached to bypass a blocked artery.
People with peripheral arterial disease (PAD) are at very high risk for heart attacks and stroke, so it is very important to manage cardiovascular risk factors. Here are some steps you can take: Quit smoking. Your health care provider can help you.... More -
Healthy Humans answered:Treatment of peripheral artery disease is similar to treatment of carotid artery disease and coronary artery disease. To prevent these diseases we have to give up tobacco use, control blood sugar, have diabetes completely under control, lipids within perfect range, and decreased amounts of inflammation. There are mechanical treatments for peripheral artery disease such as angioplasty, placing a balloon to open the artery, as well as rotational aserectomy or stent placement. Additional, treatments may include medication, supplements and even surgery.
Treatment of peripheral artery disease is similar to treatment of carotid artery disease and coronary artery disease. To prevent these diseases we have to give up tobacco use, control blood sugar, have diabetes completely under control, lipids... More -
Dr. William D. Knopf of Piedmont Heart Institute answered:Treatments for peripheral arterial disease (P.A.D.) include lifestyle changes, medicines, and surgery or procedures.
The overall goals of treating P.A.D. are to reduce symptoms, improve quality of life, and prevent complications. Treatment is based on your signs and symptoms, risk factors, and results from a physical exam and tests.
Lifestyle Changes
Treatment often includes making long-lasting lifestyle changes, such as:
- Quitting smoking. Your risk for P.A.D. increases four times if you smoke. Smoking also raises your risk for other diseases, such as coronary artery disease (CAD). Talk to your doctor about programs and products that can help you quit smoking.
- Lowering blood pressure. This lifestyle change can help you avoid the risk of stroke, heart attack, heart failure, and kidney disease.
- Lowering high blood cholesterol levels. Lowering cholesterol can delay or even reverse the buildup of plaque in the arteries.
- Lowering blood glucose levels if you have diabetes. A hemoglobin A1C test can show how well you have controlled your blood sugar level over the past 3 months.
- Getting regular physical activity. Talk with your doctor about taking part in a supervised exercise program. This type of program has been shown to reduce P.A.D. symptoms.
Medicines
Your doctor may prescribe medicines to:
- Lower high blood cholesterol levels and high blood pressure
- Thin the blood to prevent clots from forming due to low blood flow
- Help ease leg pain that occurs when you walk or climb stairs
Surgery or Procedures
Bypass Grafting
Your doctor may recommend bypass grafting surgery if blood flow in your limb is blocked or nearly blocked. For this surgery, your doctor uses a blood vessel from another part of your body or a man-made tube to make a graft. This graft bypasses (goes around) the blocked part of the artery, which allows blood to flow around the blockage. This surgery doesn't cure P.A.D., but it may increase blood flow to the affected limb.
Angioplasty
Your doctor may recommend angioplasty (AN-jee-oh-plas-tee) to restore blood flow through a narrowed or blocked artery.
This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.
Treatments for peripheral arterial disease (P.A.D.) include lifestyle changes, medicines, and surgery or procedures. The overall goals of treating P.A.D. are to reduce symptoms, improve quality of life, and prevent complications. Treatment is based... More -
Dr. Peter Faries of The Mount Sinai Medical Center answered:There are various treatments for PAD. The type of treatment is determined by the extent or severity of the disease.
If your peripheral artery disease is detected early, you can make lifestyle changes to help you manage your disease.
Exercising and walking regularly, for instance walking at least 30 minutes 3 times each week, may help improve your symptoms.
Your physician may also recommend medication to treat conditions that worsen or complicate leg artery disease. These medications may include cholesterol-lowering drugs (statins) or blood pressure-lowering medications. You may also need to take medications that reduce blood clotting to minimize the chances of clots blocking your narrowed arteries.
Your physician may also prescribe cilostazol (Pletal), which can improve the distance you are able to walk without discomfort or pain. Other drugs your physician may prescribe include aspirin and clopidogrel (Plavix), either of which can decrease your chances of developing blood clots.
In some cases of peripheral artery disease, your physician may recommend angioplasty and stenting. This procedure is considered to be minimally invasive in comparison to open surgery. It is most effective for more localized blockages in the larger arteries. In an angioplasty, your physician inserts a long, thin, flexible tube called a catheter into your artery. The catheter is guided through your arteries to the blocked area. Once in place, a special balloon, which is attached to the catheter, is inflated and deflated. The balloon pushes the plaque in your artery against your artery walls, widening the vessel. In some circumstances, your vascular surgeon may then place a tiny mesh-metal tube, called a stent, into the narrowed area of your artery to keep it open. The stent remains permanently in your artery. After this procedure, blood flows more freely through your artery.
Bypass surgery creates a detour around a narrowed, or blocked, section of a leg artery. To create this bypass, your vascular surgeon uses one of your veins or a tube made from man-made materials. Your vascular surgeon attaches the bypass above and below the area that is blocked. This creates a new path for your blood to flow to your leg tissues and is particularly effective for extensive artery blockages.
There are various treatments for PAD. The type of treatment is determined by the extent or severity of the disease. If your peripheral artery disease is detected early, you can make lifestyle changes to help you manage your disease. Exercising and... More -
Brigham and Women's Hospital answered:The first priority in chronic peripheral arterial disease (PAD) is treatment of risk factors; smoking cessation and control of blood pressure and cholesterol top the list. These measures do not necessarily improve the circulation to the legs, but they help to prevent heart attack and stroke, common serious cardiovascular complications that affect people with PAD. Another noninvasive maneuver that may improve symptoms is exercise. A cardiologist will usually perform a stress test, often involving a chemical stressor, before referring the patient to an exercise program to improve the distance he or she can walk before developing symptoms. If lifestyle-limiting symptoms persist with these noninvasive measures, imaging tests such as a magnetic resonance angiogram can define arterial anatomy. In some cases, nonsurgical revascularization approaches such as balloon angioplasty or stenting can relieve obstructions and improve symptoms. In other cases, surgical intervention is the best choice.The first priority in chronic peripheral arterial disease (PAD) is treatment of risk factors; smoking cessation and control of blood pressure and cholesterol top the list. These measures do not necessarily improve the circulation to the... More -
Dr. Jeffrey Marshall of SCAI answered:PAD is treated in several different ways, depending on its severity.
The PAD disease process is similar to the narrowing that affects heart arteries – where fatty deposits called plaque build up and eventually obstruct blood flow and raise blood pressure. As a result, the treatments are similar. They aim to promote clear, flexible healthy vessels so blood flow is restored.
The first stage of treatment strategies doctors usually recommend for mild PAD are based on lifestyle changes, and may include medications, too. Among the strategies are:
- Quit smoking - eliminating tobacco use may be the most important step you can take
- Take part in an approved exercise program, such as structured walking
- Eat a healthful, low-fat diet
- Maintain a healthy weight
- Take prescribed medications for high blood pressure, thinning the blood to prevent clots, and lowering cholesterol, as determined by your doctor
In more serious cases of PAD, where leg pain is so severe and persistent that walking is problematic, the lifestyle changes and medications may be combined with a minimally invasive procedure performed by a physician who specializes in blood vessel health, or through surgery to create a detour around the vessel blockages to restore blood flow.
PAD is treated in several different ways, depending on its severity. The PAD disease process is similar to the narrowing that affects heart arteries – where fatty deposits called plaque build up and eventually obstruct blood flow and raise... More
