The overall goals of treating P.A.D. include reducing risk of heart attack and stroke; reducing symptoms of claudication; improving mobility and overall quality of life; and preventing complications. Treatment is based on your signs and symptoms, risk factors, and the results of physical exams and tests.
Treatment may slow or stop the progression of the disease and reduce the risk of complications. Without treatment, P.A.D. may progress, resulting in serious tissue damage in the form of sores or gangrene (tissue death) due to inadequate blood flow. In extreme cases of P.A.D., also referred to as critical limb ischemia (CLI), removal (amputation) of part of the leg or foot may be necessary.
Treatment often includes making long-lasting lifestyle changes, such as:
Routine physical activity can improve P.A.D. symptoms and lower many risk factors for atherosclerosis, including LDL (“bad”) cholesterol, high blood pressure, and excess weight. Exercise can improve the distances you can comfortably walk.
Talk with your doctor about taking part in a supervised exercise program. If a supervised program is not an option, ask your doctor to help you develop an exercise plan. Most exercise programs begin slowly, which includes simple walking alternating with rest. Over time, most people build up the amount of time they can walk before developing pain. The more active you are, the more you will benefit.
If you smoke, quit. Smoking raises your risk for P.A.D. Smoking also raises your risk for other diseases, such as coronary heart disease and heart attack, and worsens other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
Read more about quitting smoking at Smoking and Your Heart.
Your doctor may recommend heart-healthy eating to treat atherosclerosis, the most common cause of P.A.D. Following heart-healthy eating can help control blood pressure and cholesterol levels, which can lead to atherosclerosis.
Your doctor may prescribe medicines to:
- Prevent blood clots from forming due to low blood flow with anticlotting medicines, such as aspirin.
- Treat unhealthy cholesterol levels with statins. Statins control or lower blood cholesterol. By lowering your blood cholesterol level, you can decrease your chance of developing complications from P.A.D.
- Treat high blood pressure with one of many high blood pressure medicines.
- Help ease leg pain that occurs when you walk or climb stairs.
- Reduce the symptoms of intermittent claudication, measured by increased walking distance with certain platelet-aggregation inhibitors.
Surgery or Procedures
Your doctor may recommend bypass grafting surgery if blood flow in your limb is blocked or nearly blocked. For this surgery, your doctor uses a blood vessel from another part of your body or a synthetic tube to make a graft.
This graft bypasses (that is, goes around) the blocked part of the artery. The bypass allows blood to flow around the blockage. This surgery doesn’t cure P.A.D., but it may increase blood flow to the affected limb.
Angioplasty and Stent Placement
Your doctor may recommend angioplasty to restore blood flow through a narrowed or blocked artery.
During this procedure, a catheter (thin tube) with a balloon at the tip is inserted into a blocked artery. The balloon is then inflated, which pushes plaque outward against the artery wall. This widens the artery and restores blood flow.
A stent (a small mesh tube) may be placed in the artery during angioplasty. A stent helps keep the artery open after angioplasty is done. Some stents are coated with medicine to help prevent blockages in the artery.
Atherectomy is a procedure that removes plaque buildup from an artery. During the procedure, a catheter is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off plaque.
The bits of plaque are removed from the body through the catheter or washed away in the bloodstream (if they’re small enough).
Doctors also can perform atherectomy using a special laser that dissolves the blockage.
Other Types of Treatment
Researchers are studying cell and gene therapies to treat P.A.D. However, these treatments aren’t yet available outside of clinical trials. Read more about clinical trials.