Peripheral Artery Disease - Treatment - Treatment

Treatment depends on how severe your PAD is and what complications you may develop or may already have. Your treatment plan will be designed to help you reach key goals:

• Reduce your risk of a major health problem such as a heart attack or stroke
• Reduce symptoms of PAD
• Improve your ability to walk, climb stairs, and perform other daily activities
• Lower your risk of losing a limb
• Improve your quality of life

To treat PAD, your doctor may recommend heart-healthy lifestyle changes, an exercise program, medicine, or a procedure to open or bypass blockages in your arteries.

Heart-healthy lifestyle changes

Your doctor may recommend that you adopt lifelong heart-healthy lifestyle changes.

• Quit smoking. Smoking is the main risk factor for PAD. Quitting can reduce your symptoms and your risk of complications. It is also important to avoid secondhand smoke. Visit Smoking and Your Heart and the National Heart, Lung, and Blood Institute’s Your Guide to a Healthy Heart. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
• Choose heart-healthy foods, such as those in the DASH eating plan. A heart-healthy eating plan includes fruits, vegetables, and whole grains and limits saturated fats, sodium (salt), added sugars, and alcohol.
• Aim for a healthy weight. If you are overweight, losing just 3% to 5% of your current weight can help you manage some PAD risk factors, such as high blood cholesterol and diabetes. Losing even more weight can lower your blood pressure.
• Get regular physical activity. Staying physically active can help you manage PAD risk factors such as high blood cholesterol, high blood pressure, and overweight or obesity. Before starting any exercise program, ask your doctor what level of physical activity is right for you.
• Manage stress. Learning how to manage stress, relax, get good-quality sleep, and cope with problems can improve your emotional and physical health.

Exercise programs

Physical activity often works well to relieve PAD symptoms and improve your ability to walk and carry out daily activities. Regular physical activity can improve the circulation in your legs. Exercise can reduce inflammation and help your blood vessels work better.

Supervised exercise

Your doctor may recommend a supervised exercise program that takes place in a clinic or a hospital. The exercise program may be part of a more complete cardiac rehabilitation program.

PAD exercise programs usually meet at least three times a week and last between 12 and 36 weeks. The most common type of exercise is walking on a treadmill. Other programs may use a device to exercise the upper body. Talk with your doctor about your options for exercise programs.

Home exercise programs

Your doctor may recommend a home-based exercise program with coaching that is similar to a supervised exercise program in a clinic. Home-based programs usually involve walking outside instead of on a treadmill. Your doctor will talk with you to help you understand how to do the program. Each exercise session lasts about 30 to 50 minutes. The goal is to work up to at least 30 minutes of continuous walking.

The programs include health coaching or activity monitors. Some home-based programs include regular check-ins with a coach by telephone. Talk with your doctor regularly about your progress.

Medicines

Your doctor may prescribe medicines to treat PAD and prevent its complications.

• Antiplatelet medicines, such as aspirin or clopidrogrel, to prevent blood clots from forming and narrowing the arteries even further. These medicines also lower the risk of heart attack or stroke. Possible side effects include bleeding or an allergic reaction. One type of antiplatelet medicine, cilostazol, may also improve your symptoms and make walking easier. Possible side effects of cilostazol include headache, diarrhea, heart palpitations, and dizziness. Doctors may also recommend an anticoagulant medicine, or blood thinner, to help prevent blood clots.
• Statins  to slow the progression of plaque buildup in the arteries that are causing symptoms and to lower your risk of complications from PAD. Side effects are rare but may include muscle pain or damage.
• ACE inhibitors and angiotensin II receptor blockers (ARBs) or other medicines to lower blood pressure and prevent blood vessels from narrowing.

Procedures or surgery

If lifestyle changes, an exercise program, and medicines do not work well enough, your doctor may recommend a medical procedure or surgery.

• angioplasty to open narrowed or blocked arteries. Your doctor may inflate a small balloon in the artery to flatten the plaque. Sometimes the balloon is coated with medicine to help the artery heal. Your doctor may also insert a small mesh tube called a stent to reduce the chances of the artery from narrowing again.

• Bypass surgery to treat severe pain, heal wounds, or save a damaged foot or leg when angioplasty is not as likely to work. Your doctor uses one of your other blood vessels or an artificial vessel to create a path around the blocked artery in your leg.