Peripheral Arterial Disease Treatment Options
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How peripheral arterial disease (PAD) is treated depends on the progression of the disease. When the disease is caught early enough, a few simple lifestyle modifications and continuous vigilance may be the best approach. In this case, one of our vascular specialists may instruct you to introduce some form of exercise into your daily activities, or prescribe medications to:
- Lower blood pressure and cholesterol levels,
- Prevent the formation of blood clots that could cause a heart attack or stroke,
- Help reduce pain while walking or climbing stairs.
In addition to these modifications, we will schedule occasional checkups to monitor the progression of the disease.
Unfortunately, most patients aren’t aware of their PAD until it requires some form of intervention. In this case, we may still suggest incorporating exercise and medications, but our attention then shifts to the arteries themselves in order to return blood to the legs. This is done during a safe, minimally invasive procedure called an angiogram; during an angiogram, we enter the arteries through a small incision–typically in the groin, though we may access from other areas depending on your condition and the locations of your blockages–and insert a series of flexible wires and catheters to visualize the vasculature. Through this method, we are able to locate the areas where blood cannot easily pass, and take the appropriate steps to restore blood flow. This is usually done by a combination of atherectomy, angioplasty, and possibly stenting. Angiograms are not long procedures, and the patient is usually able to go home by the end of the day after a short period of recovery in one of our private suites.
Atherectomy is the removal of plaque from a blood vessel. There are many different forms of atherectomy, and we vary what form we use depending on the circumstances of the blockage–size, composition, location. Typically, we use laser atherectomy; a superheated laser zaps the plaque away, allowing for blood to flow more easily. In cases where the plaque is heavily calcified, we may opt for orbital atherectomy, where a very small stud is rotated through the plaque, shaving away the hardened blockage and making the artery pliable enough to undergo balloon angioplasty.
Stents are small tubes made of a metal mesh that can be used to provide backing to the arterial wall, assisting in keeping the artery open. Once put in place, stents remain as permanent structures in the vasculature.