Peripheral Artery Disease (PAD): Treatment Options
How is PAD treated?
Lifestyle changes, medications and interventional procedures are the treatments available for PAD.
Lifestyle Changes. Initial treatment of PAD includes making lifestyle changes to reduce your risk factors. Changes you can make to manage your condition include:
- Quit smoking. Ask your doctor about smoking cessation programs available in your community.
- Eat a balanced diet that is high in fiber and low in cholesterol, fat and sodium. Limit fat to 30 percent of your total daily calories. Saturated fat should account for no more than 7 percent of your total calories. Avoid trans fats including products made with partially-hydrogenated and hydrogenated vegetable oils. If you are overweight, losing weight will help you lower your total cholesterol and raise your HDL (good) cholesterol. A registered dietitian can help you make the right dietary changes.
- Exercise. Begin a regular exercise program, such as walking. Walking is very important and can aid the treatment of PAD. Patients who walk regularly can expect a marked improvement in the distance they are able to walk before experiencing leg pain. (See Walking Program Box)
- Manage other health conditions, such as high blood pressure, diabetes or high cholesterol.
- Practice good foot and skin care to prevent infection and reduce the risk of complications. (See Foot Care Guidelines Box)
Medications may be recommended to treat conditions such as high blood pressure (anti- hypertensive medications) or high cholesterol (statin medications).
An antiplatelet medication such as aspirin or clopidogrel (Plavix) may be prescribed to reduce the risk of heart attack and stroke.
Vascular Medicine and Preventive Cardiology and Rehabilitation offer a structured supervised walking program to help you succeed and maximize your exercise efforts. Please call 216.444.4420 or 800.223.2273 ext. 4420 to make an appointment.
Cilostazol (Pletal) may be prescribed to improve walking distance. This medication has been shown to help people with intermittent claudication exercise longer before they develop leg pain and to walk longer before they must stop because of the pain. However, not all patients are eligible to take this medication. Your doctor will tell you if you are eligible.
Interventional procedures. More advanced PAD can be treated with interventional procedures such as angioplasty (to widen or clear the blocked vessel), angioplasty with stent placement (to support the cleared vessel and keep it open), or atherectomy (to remove the blockage).
In some cases, surgical procedures such as peripheral artery bypass surgery may be performed to reroute blood flow around the blood vessel blockage.
New therapies are currently being researched. Please ask your doctor if any other treatment options are available for you.
If any of these procedures are recommended, your health care team will give you more information about the procedures so you will know what to expect.
Can PAD be cured?
There is no cure for PAD. Quitting smoking, exercising regularly, limiting fat and following a healthy diet, and managing your risk factors — such as diabetes, high cholesterol and high blood pressure — can help to reduce the progression of the disease.
Foot Care Guidelines
Every day, examine your legs as well as the tops and bottoms of your feet and the areas between your toes. Look for any blisters, cuts, cracks, scratches or other sores. Also check for redness, increased warmth, ingrown toenails, corns and calluses. Use a mirror to view the leg or foot if necessary, or have a family member look at the area for you.
Once or twice a day, apply a moisturizing cream or lotion to your legs and soles and top of your feet to prevent dry skin and cracking. Do not apply lotion between your toes or on areas where there is an open sore or cut. If the skin is extremely dry, use the moisturizing cream more often. Care for your toenails regularly. Cut your toenails after bathing, when they are soft. Cut toenails straight across and smooth with a nail file.
If you have diabetes, it is important to see a podiatrist.
Do not self-treat corns, calluses or other foot problems. Go to a podiatrist to treat these conditions.
Don't wait to treat a minor foot or skin problem. Follow your doctor's guidelines.
Other tests may include angiography, CT scan or MRI.
During angiography (also called arteriography), contrast material (dye) is injected into the blood vessels being examined, and X-ray pictures of the inside of the blood vessels are produced to evaluate blood flow and detect possible blockages.
A CT scan is a technique in which multiple X-rays are taken from different angles in a very short period of time. The images are collected by a computer and cross-sectional “slices” of the blood vessel are shown on the monitor.
MRI uses powerful magnets to create images of internal organs and blood vessels.