The severity of your PAD and any consequences you may already be experiencing will determine what treatments are best for you. Important targets for your treatment plan may include:
- Lowering one's chances of experiencing a life-threatening illness like a heart attack or stroke
- Improvements in PAD symptoms
- Enhanced mobility for strolling, stair climbing, and other routine tasks
- Eliminating or significantly reducing the potential for limb loss
- Boosting your standard of living
Your healthcare provider may suggest making heart-healthy lifestyle changes, beginning an exercise program, prescribing medication, or performing a surgical operation to open or bypass your blocked arteries as a treatment for PAD.
Peripheral artery disease (PAD) has no known treatment; however, it can be managed with diet, exercise, and medication. The risk of getting more CVD (cardiovascular diseases) can be reduced by using these medications, specifically for:
- Coronary heart disease
- Stroke
- Heart attack
Having PAD indicates that your blood vessels are unhealthy, making treatment more crucial. When non-surgical options have failed, surgery may be considered.
Lifestyle Changes
If you have PAD, the best things you can do for your health are to start exercising regularly and, if you smoke, to give up the habit altogether.
Exercise
Exercising regularly has been shown to lessen the frequency and severity of PAD symptoms and lower the chance of acquiring another cardiovascular disease. The benefits of exercise don't end with only physical health.
When it comes to treating PAD, the first line of defense is supervised exercise, according to the National Institute for Health and Care Excellence (NICE). One option is group fitness classes led by a trainer with other people who also have CVD.
In most cases, the recommended exercise regimen entails three months of twice-weekly supervised physical activity. Ideally, you'd exercise every day for the remainder of your life, as the benefits of exercise diminish rapidly if they're not regular and consistent.
Simply going about is a great way to get some exercise. Until the discomfort becomes unbearable, it is recommended that you walk as far and as long as possible. Just stay in bed till the pain disappears. Get back on your feet and keep going till the ache returns. You should continue this "stop-start" pattern. The recommended frequency is multiple times each week.
Having to deal with pain regularly during the exercise program is difficult. On the other hand, it ought to alleviate your symptoms.
Stop Smoking
If you want to reduce your risk of PAD worsening and developing another major CVD, you should quit smoking. According to studies, those who continue to smoke after being diagnosed with heart disease are significantly more likely to suffer a heart attack or pass away from a related issue.
Other Lifestyle Changes
The risk of getting cardiovascular disease (CVD) can be decreased by making several adjustments to one's lifestyle, not just by exercising and giving up smoking.
A few examples are as follows:
- Eating a balanced meal
- Keeping a Healthy Weight
- Reducing one's alcohol intake
Physical and mental health PAD can bring excruciating agony and a shattered existence. Getting help for your mental health is essential if you struggle with depression or anxiety.
Diabetes
Diabetes, primarily if not well managed, can exacerbate PAD symptoms and increase the risk of additional CVDs.
Proper diabetes management can necessitate adjustments to one's way of life. Methods to control diabetes include dietary changes like cutting back on sugar and fat and medication.
Medicines
The risk of getting another cardiovascular disease can be lowered while treating the underlying causes of PAD with various medications. While some people may only require one or two of the medications listed below, others may need to take many.
Statins
It is common practice to administer statins to patients whose blood tests reveal elevated LDL cholesterol levels ("bad cholesterol").
Statins lower cholesterol levels by inhibiting the liver from making LDL cholesterol.
While most people who use statins report minimal or mild side effects, some suffer.
- Indigestion
- Headaches
- Nausea (Feel sick)
- Muscle aches
Antihypertensives
When blood pressure levels go too high, doctors turn to Antihypertensives (hypertension). A doctor may recommend an antihypertensive medication if you have:
- Your blood pressure is over 140/90 mm Hg, and you do not have diabetes.
- If your BP is around 130 over 80, you have diabetes.
Angiotensin-converting enzyme (ACE) inhibitors are a popular class of anti-hypertensive because they work by preventing the effects of hormones that play a role in blood pressure regulation. Your blood pressure will go down as a result of this. Inhibitors of adenosine conversion enzyme (ACE) might have the following unwanted effects:
- Dizziness
- Fatigue or weakness
- Headaches
- Dry, persistent cough
Though most people recover from these symptoms within a few days, some may experience a dry cough that lasts longer. An angiotensin-2 receptor antagonist is a comparable medication that may be suggested if the adverse effects become too severe.
Blood-thinning Medicines
When you have atherosclerosis, a fatty deposit (plaque) breaks off from the artery wall and can cause serious problems. A blood clot may form at the site of the plaque rupture as a result.
A heart attack can be brought on by forming a blood clot within a coronary artery. When a clot forms in one of the brain's blood veins, it can cause a stroke like a heart attack does.
To lower the patient's risk of developing dangerous blood clots, anticoagulant medication is commonly administered to those diagnosed with PAD. This medication reduces the likelihood of blood clots by thinning the blood.
If your doctor diagnoses you with PAD, they may prescribe you blood-thinning medications such as:
- Clopidogrel
- Low-dose aspirin
- Rivaroxaban
Naftidrofuryl-oxalate
A small number of patients may utilize this medication instead of surgery to increase blood flow if they prefer not to undergo the procedure. It can also be employed if you've tried supervised exercise but haven't seen any change in your condition.
The possible adverse effects of naftidrofuryl-oxalate include:
- Feeling sick
- Rashes
- Diarrhea
- Abdominal pain
Naftidrofuryl-oxalate is often prescribed for 3 to 6 months to assess for symptomatic improvement. After that time, the treatment will be discontinued if it has not been successful.
Surgery and Procedures
Occasionally, surgery to unblock the arteries in your legs will be recommended. Revascularization describes this procedure. If your leg discomfort is severe enough to prohibit you from performing everyday activities, or if your symptoms have not improved with the treatments mentioned above, revascularization may be indicated.
For PAD, revascularization comes in two primary forms:
- Angioplasty: Balloon angioplasty involves inflating a small balloon inside the artery to expand a constricted or obstructed segment.
- Artery bypass graft: A bypass graft is a surgical procedure in which healthy blood arteries from another body section are transplanted into a blocked artery.
Which Procedure is Best?
Angioplasty and bypass grafts may be necessary for tandem in some situations. If so, you must understand the benefits and drawbacks of each option.
When compared to a bypass, an angioplasty is less intrusive. You only need a small incision for this treatment, which can be done in one day with a local anesthetic. This means you can have the procedure done throughout the day and go home the same day.
Unless angioplasty is not an option or has already failed, bypass surgery is typically chosen instead of angioplasty.
While angioplasty can have immediate results, bypass surgery is thought to be more permanent. Because of this, the operation may require fewer repeats than angioplasty.
Aneurysm angioplasty and coronary artery bypass grafting have a small risk of serious consequences, including heart attack, stroke, and death. Although there is limited research comparing angioplasty and bypass surgery for PAD, some evidence suggests the risk of significant complications is similar in both procedures.
Your care team will include specialists in surgery, medicine, and nursing who will examine all of your treatment choices with you before making a final recommendation.