|Home > Medicine > Cardiovascular Disorders|
The overall goals for treating peripheral arterial disease (PAD) are to reduce symptoms, improve quality of life, and prevent complications. Treatment is based on symptoms, risk factors, physical exam results, and diagnostic tests.
Specific treatments for PAD include lifestyle changes, medicines, and surgery or special procedures.
Treatment often includes making long-lasting lifestyle changes, such as:
Talk with your doctor about participating in a supervised exercise therapy program. Follow a low-saturated fat, low-cholesterol diet, and eat foods with less salt, total fat, and saturated fat. Eat more fruits, vegetables, and low-fat dairy products. If you are overweight or obese, work with your doctor to develop a reasonable weight-loss plan. If you are diabetic or at risk for critical limb ischemia, have your feet examined regularly.
Medicines may be prescribed to:
Some medicines lower the level of low density lipoprotein (LDL) cholesterol. LDL is the "bad" cholesterol. The higher the LDL level in the blood, the greater the chance of heart disease. Medicines may include statins, such as lovastatin, simvastatin, pravastatin, fluvastatin, and atorvastatin. Other medicines may include ezetimibe, gemfibrozil, and certain binding agents.
Blood pressure should be lowered if it is too high. Treatment should aim for a blood pressure lower than 130/80 mmHg. Many medicines are available to lower blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, diuretics ("water pills"), and calcium channel blockers.
Anticoagulants or blood thinners may be prescribed to prevent clots in the arteries. Thrombolytic therapy involves clot-dissolving drugs inserted into an artery to break up a blood clot. To stop platelets from clumping together, antiplatelet drugs such as clopidogrel (Plavix) and aspirin may be prescribed. To help increase distances walked without pain and help improve claudication, pentoxifylline (Trental) or cilostazol (Pletal) may be prescribed.
Surgeries or Special Procedures
Surgery may be necessary if blood flow in a limb is completely or almost completely blocked. In bypass grafting surgery, the doctor uses a blood vessel from another part of your body or a tube made of synthetic (man-made) material to make a graft. This graft bypasses the blockage in the artery, allowing blood to flow around it. Surgery does not cure PAD, but it may increase blood flow to the limb.
Angioplasty may be performed to restore blood flow through a narrowed or blocked artery. During the procedure, a thin tube (catheter) is inserted into a blocked artery and a small balloon on the tip of the catheter is inflated. When the balloon is inflated, plaque is pushed against the artery walls. This causes the artery to widen, restoring blood flow. A stent, a tiny mesh tube that looks like a small spring, is now used in most angioplasties. Some stents are coated with medicine to help prevent the artery from closing again.