What Is the Best Treatment for Peripheral Artery Disease?

PAD treatment can change as the disease progresses. Early PAD is often treated without a procedure. It often responds well to regular walking. Medication may be needed, too, depending on your symptoms. But when a blockage becomes more severe, treatment may need to focus directly on the artery. Angioplasty can open the narrowed area, while a stent may help keep it open afterward. Atherectomy can also be used to remove plaque.

PAD is treatable, and finding it early can help keep it from getting worse. Your doctor can determine how severe the blockage is and how much it has affected circulation. The symptoms you’re having will also factor into the treatment recommendation. Below, we’ll break down the PAD treatments used at different stages and when a procedure may be needed.

The Best PAD Treatment Depends on Your Stage

PAD symptoms can change as the disease progresses. You might first notice your calves cramping during a walk and feel better after sitting down for a few minutes. Medication may help at this stage. A supervised walking program can help you build up your walking distance as well.

Leg pain that interferes with walking or daily activities can mean it’s time to look at procedures that open the artery.

With severe PAD, pain can continue even when you’re resting. Sores on the feet or toes may take longer to heal. These symptoms can mean that blood flow to the leg has become severely restricted. When blood flow gets this low, the tissue in the leg can start to die. Getting blood flowing again quickly may stop the damage before it becomes severe enough to require amputation.

First-Line PAD Treatment: Lifestyle Changes and Medication 

Mild PAD symptoms don’t always call for a procedure. Medication may be part of your PAD treatment. Regular walking can help you build up the distance you can cover before symptoms begin. Smoking is another issue to address because it can make PAD worse.

Walking can be one of the hardest recommendations to understand. After all, walking may be what brings on your leg pain. Supervised walking builds your tolerance for longer walks. The goal is to walk farther before your legs start hurting.

There are other changes that can help, too. Smoking can make PAD worse, so quitting can slow the disease. Your doctor may prescribe medications to lower cholesterol and blood pressure or help prevent blood clots.

Minimally Invasive Treatments That Restore Blood Flow

If your PAD symptoms are getting worse, your doctor may recommend a minimally invasive treatment that doesn’t require open surgery. 

Angioplasty

Angioplasty may be an option if medication and walking haven’t done enough to improve your symptoms. 

During angioplasty, your doctor guides a small balloon to the blockage and inflates it. The balloon presses the buildup against the artery wall, making more room for blood to flow. It is then deflated and removed.

Stent Placement

An artery may need extra support after it’s been opened. A stent is a small mesh tube that stays inside the artery. The mesh tube props the artery open from the inside. It stays in place after the procedure.

Atherectomy

Some artery blockages are caused by a fatty buildup called plaque that can harden over time. Atherectomy removes plaque from inside a narrowed or blocked artery. A thin tube travels through the artery to the blockage. Once there, a small device removes the buildup.

Angioplasty, stent placement, and atherectomy are performed through a small pinhole puncture instead of an open incision. They are outpatient treatments, which means you can go home the same day.

When Is Surgery Necessary for PAD?

Most people with PAD won’t need major surgery. Angioplasty, stent placement, and atherectomy can treat blocked arteries through a small puncture in the skin. These procedures reopen the artery so blood can reach the lower leg and foot.

This becomes urgent when PAD progresses to rest pain, non-healing wounds, ulcers, or gangrene. At that point, too little blood may be reaching the tissue for a wound to heal. American Endovascular’s doctors can treat blockages in the small arteries of the ankle, foot, and toes, including difficult blockages that may put the limb at risk. They have saved limbs in patients who were previously told they needed a major amputation.

How Doctors Decide Which PAD Treatment Is Best for You

Your doctor first needs to know how well blood is reaching your legs and feet. A painless test called an ankle-brachial index (ABI) compares the blood pressure in your ankle and arm.  

Imaging can show what’s happening inside the arteries and where blood flow is being restricted.

Besides testing, your doctor will want to know when the pain starts and what you’re doing when it happens. They may also ask whether the pain is getting in the way of your usual activities. For example, the pain may start when you walk. In more advanced cases, it can continue even after you stop. 

This information helps your doctor see how PAD is affecting blood flow and how severe the blockage is. That may mean managing the disease with medication or opening the artery itself.

What Happens If PAD Goes Untreated?

PAD can get worse as the arteries become more narrowed and less blood reaches the legs and feet. Leg pain may also become more frequent or start happening while you’re resting. Sores on the feet or toes may also take longer to heal. In severe cases, reduced blood flow can damage tissue and put the leg at risk.

A serious blockage can eventually damage the leg if too little blood is getting through. Early treatment can lower the risk of amputation.

Frequently Asked Questions

Can PAD be treated without surgery?

Yes. Many people with PAD can manage their symptoms without surgery. Treatment may include medication and regular walking, but a more serious blockage may require a procedure to restore blood flow.

Can PAD be reversed?

There’s no cure for PAD. Treatment focuses on improving symptoms and keeping the disease from getting worse. The most severe form of PAD may result in acute limb ischemia, which has a high likelihood of amputation. 

What is the best treatment for blocked arteries in the legs?

A mild blockage may respond to medication and supervised walking. If the blockage is cutting off too much blood flow, opening the artery may be the better option. Angioplasty or atherectomy may be used to treat a narrowed or blocked artery. Stent placement can restore proper blood flow.

When does PAD require a procedure? 

When PAD symptoms continue despite treatment, your doctor may recommend a procedure to improve blood flow. Find Out Which PAD Treatment Is Right for You

You don’t have to guess how serious your PAD is or which treatment you need. 

Don’t wait for PAD symptoms to limit your mobility. Call (833) 226-7044 or request a consultation with American Endovascular & Amputation Prevention’s highly skilled affiliated vascular specialists today!