Proper PAD Treatment Options
By: Dr. Ashwani Kumar
Peripheral artery disease, or PAD, occurs when a buildup, known as plaque, forms on the walls of your arteries. Plaque is typically formed by fat deposits or cholesterol, but it can also be created by calcium or fibrous tissue found in your blood. The buildup of plaque, called atherosclerosis, can cause your artery walls to narrow or harden, which reduces the flow of blood through your body. PAD commonly occurs in your legs, but it can also occur in your arteries in your neck, arms, kidneys and stomach. If left untreated, PAD can lead to serious medical complications such as gangrene and even limb amputation.
What are the Risk Factors of PAD?
The risk factors of PAD are: having high blood pressure, diabetes, being overweight or obesity, smoking, having a family history of atherosclerosis, or having high cholesterol levels. While we aim to control these factors through good lifestyle choices, sometimes additional intervention is necessary.
What are the Symptoms of PAD?
The first sign that you have PAD is when you experience pain in your legs when you walk. This pain may only be relieved when you rest. Then over time, you may find that the pain occures with less exertion. You might then begin to experience cramps in your calf muscles when you are not moving. These cramps often become increasingly more frequent and intense. The next stage of PAD is the appearance of ulcers on your feet that don’t heal. If this occurs, then you are at risk of getting gangrene in the affected area, which can result in the loss of a limb.
What Types of PAD Treatment is Available?
There are a number of PAD treatments available that can help alleviate your symptoms. These treatments include: lifestyle changes, medication, and revascularization.
- Lifestyle changes: Diet, exercise and smoking cessation can help to reduce the symptoms of PAD and atherosclerotic process, in some cases, the need for further treatment. It is important that lifestyle modifications begin at the first diagnosis of PAD and are incorporated into your daily life. In some cases lifestyle modification may be supplemented by medication or surgery.
- Medication: Depending on the causes of your PAD, there are a number of medications available that help in controlling atherosclerotic process. The most common medications are those that reduce cholesterol and fat in the body, such as Statins, Fibrates and Niacin, and blood thinners that reduce blood clots, such as aspirin, clopidogrel. Medication that reduces high blood pressure and control diabetes may also be prescribed.
- Revascularization: Revascularization can be achieved either with endovascular techniques or with surgical bypass.
- Endovascular Techniques: This is minimally invasive technique to establish the flow in the blocked up artery. There are three procedures that you can have to remove an arterial blockage that occurred as a result of PAD. The first procedure is a balloon angioplasty in which a balloon-tipped catheter is inserted and guided to the arterial blockage by X-ray imaging. Once at the site, the balloon is then inflated until the blockage is removed. The balloon is then deflated and removed. The second procedure is the insertion of a stent, a small wire mesh or artificial artery wall, which is used to reinforce the artery and keep it open. The third procedure is an atherectomy, where the buildup of plaque is removed by scraping it from the artery wall.
- Surgical: There are two surgical procedures to achieve revascularization: surgical bypass or endarterectomy.
The type of treatment you have will depend on the severity of your peripheral artery disease and whether or not other treatments have been successful. Our goal is to reduce your symptoms, to prevent further complications, and to improve your quality of life.
If you’d like to know more about peripheral artery disease and your treatment options, please contact Virginia Cardiovascular Specialists to schedule an appointment.
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Published June 14, 2019