How Is Peripheral Arterial Disease Treated?

Treatments for peripheral arterial disease (P.A.D.) include lifestyle changes, medicines, and surgery or procedures.

The overall goals of treating P.A.D. include reducing symptoms, improving quality of life, and preventing 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 of P.A.D. increases four times if you smoke. Smoking also raises your risk for other diseases, such as coronary heart disease (CHD). Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
• 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. Lowering cholesterol can delay or even reverse the buildup of plaque in your arteries.
• Lowering blood glucose (sugar) 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.
• Being physically active. 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.

Follow a healthy eating plan that's low in total fat, saturated fat, trans fat, cholesterol, and sodium (salt). Include fruits, vegetables, and low-fat dairy products in your diet. If you're overweight or obese, work with your doctor to create a reasonable weight-loss plan.

Two examples of healthy eating plans are Therapeutic Lifestyle Changes (TLC) and Dietary Approaches to Stop Hypertension (DASH).

Medicines

Your doctor may prescribe medicines to:

• Treat unhealthy cholesterol levels and high blood pressure
• Prevent blood 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 (that is, goes around) the blocked part of the artery. The bypass 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 and Stenting

Your doctor may recommend angioplasty (AN-jee-oh-plas-tee) to restore blood flow through a narrowed or blocked artery.

During this procedure, a catheter (thin tube) with a balloon at the tip is inserted into a blocked artery. The balloon is then inflated, which pushes plaque outward against the artery wall. This widens the artery and restores blood flow.

A stent (a small mesh tube) may be placed in the artery during angioplasty. A stent helps keep the artery open after angioplasty is done. Some stents are coated with medicine to help prevent blockages in the artery.

Atherectomy

Atherectomy (ath-eh-REK-to-me) is a procedure that removes plaque buildup from an artery. During the procedure, a catheter is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off plaque.

The bits of plaque are removed from the body through the catheter or washed away in the bloodstream (if they're small enough).

Doctors also can do atherectomy using a special laser that dissolves the blockage.

Other Types of Treatment

Researchers are studying cell and gene therapies to treat P.A.D. However, these treatments aren't yet available outside of clinical trials.

For more information about clinical trials, go to the "Clinical Trials" section of this article or the Health Topics Clinical Trials article.

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