Peripheral Artery Disease: Treatment Overview

Peripheral artery disease (PAD) is a health issue where narrowed arteries limit blood flow to the limbs. A buildup of fatty plaque in the arteries can lead to a blockage in the blood vessels, leading to various symptoms. It is most common in the arteries of the legs, which can cause pain and difficulty walking. About 8.5 million Americans aged 40 and older suffer from PAD, according to a study from the American Heart Association (AHA).

Treatment options can help manage PAD. Continue reading for an overview of treatments for PAD, including lifestyle changes, exercise, medication and medical procedures.

Lifestyle Changes for PAD

Making changes in your daily habits is an important part of managing PAD and lowering the risk of serious heart-related problems. For example, quitting smoking may help slow down PAD progression and decrease the risk of heart issues. Behavioral therapy and nicotine replacement therapy can help people quit smoking and improve their heart health. Another example is diabetes; having diabetes increases the risk PAD and limb-related complications in those with PAD so managing your diabetes is important.

Supervised exercise therapy (SET) programs may also help those with lower-extremity PAD. These programs may vary in length and duration. However, an example of a program may include a minimum of 30- to 45-minute exercise sessions at least three times per week for 12 weeks. Although these exercise programs might not improve the chances of living longer, they may improve walking ability, overall functional status, and quality of life.

Medication for Peripheral Artery Disease

If exercise and lifestyle changes don't help, doctors may prescribe medication for PAD. Taking the medication prescribed by your healthcare professional is crucial for managing PAD and reducing the risk of heart attack and stroke. Depending on your condition and risk factors, you may be prescribed the following medications:

• Antiplatelet agents, such as aspirin or clopidogrel, to prevent blood clots.
• Oral anticoagulants, such as warfarin or rivaroxaban (Xarelto®), to reduce the risk of blood clots
• Cholesterol-lowering medications, such as atorvastatin or simvastatin, to decrease cholesterol levels, which may reduce symptoms and decrease the risk of a heart attack or stroke
• High blood pressure medications, such as lisinopril or losartan, for people with PAD and high blood pressure

If you have claudication, a condition that causes leg pain while walking, your healthcare professional may prescribe a medication called cilostazol to help improve your walking distance. Always consult your healthcare professional about the medications you may need based on your condition and risk factors.

Medical Procedures for PAD

In some cases, patients may need medical procedures like endovascular treatment, surgery or a combination of both to treat PAD. These treatments are usually considered when symptoms are severe and not improving with other therapies.

Surgical procedures include the following:

• Angioplasty or stent insertion: During these procedures, a small incision is made to insert a catheter into the blocked artery. A tiny balloon is then inflated within the artery to clear the blockage. A small wire mesh tube, known as a stent, may also be placed to help keep the artery open. In some cases, medication can be delivered through the catheter, or a specialized device can be used to eliminate a clot obstructing the artery.
• Bypass surgery: A healthcare provider may recommend bypass surgery if a long section of an artery in your leg is entirely blocked and you're suffering from severe symptoms. In this procedure, a vein from another part of the body is used to create a detour around the blocked artery, restoring blood flow.
• Atherectomy: This procedure involves the use of a catheter with a sharp cutting edge to remove plaque buildup from the artery. A healthcare provider will insert a catheter into the obstructed artery and use the attached blade to cut, collect and remove the plaque.

Your healthcare provider will help you determine which treatment option is most suitable for your specific situation. Factors such as overall health and the severity of the disease will help your healthcare team determine the best course of action.

Key Takeaway

Treating peripheral artery disease starts with changing daily habits to prevent the disease from getting worse. Medical treatments and procedures can also help manage symptoms and reduce the risk of heart problems. Working closely with a healthcare team is important for finding the best treatment plan. By following the right plan, people with PAD can improve their quality of life and reduce the risk of future heart-related issues.

Sources:

• https://www.cdc.gov/heart-disease/about/peripheral-arterial-disease.html
• https://www.heart.org/en/health-topics/peripheral-artery-disease/prevention-and-treatment-of-pad
• https://www.ncbi.nlm.nih.gov/books/NBK557482/
• https://heart.bmj.com/content/107/22/1835