Peripheral Artery Disease (P.A.D.)
Living with and Treating P.A.D.
Living With P.A.D.
If you have P.A.D., you may feel pain in your calf or thigh muscles after walking. Try to take a break and allow the pain to ease before walking again. Over time, this may increase the distance that you can walk without pain. Talk with your doctor about taking part in a supervised exercise program. This type of program has been shown to reduce P.A.D. symptoms.
If you have P.A.D., you should check your feet and toes regularly for sores or possible infections. Wear comfortable shoes that fit well. Maintain good foot hygiene and have professional medical treatment for corns, bunions, or calluses.
See your doctor for checkups as he or she advises. If you have P.A.D. but don't have symptoms, you should still see your doctor regularly. Take all medicines as your doctor prescribes.
Who Treats P.A.D.?
Primary care doctors, such as internists and family doctors, may treat people who have mild P.A.D. For more advanced P.A.D., a vascular specialist may be involved. This is a doctor who specializes in treating blood vessel diseases and conditions.
A cardiologist also may be involved in treating people who have P.A.D. Cardiologists treat heart problems, such as coronary heart disease and heart attack, which often affect people who have P.A.D.
Goals of Treatment
The overall goals of treating P.A.D. include reducing risk of heart attack and stroke; reducing symptoms; improving the ability to move 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 for P.A.D. may slow or stop the progress of the disease and reduce the risk of complications. Without treatment, P.A.D. may progress, resulting in serious tissue damage due to inadequate blood flow. In extreme cases of P.A.D., also referred to as critical limb ischemia, removal (amputation) of part of the leg or foot may be necessary.
Treatments for P.A.D. include
- lifestyle changes
- surgery or procedures.
Lifestyle changes can help prevent or delay P.A.D. and other related problems, such as coronary heart disease, heart attack, stroke, and transient ischemic attack (mini-stroke). Lifestyle changes include
- physical activity
- quitting smoking
- a heart healthy diet.
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 or developing an exercise plan. Most exercise programs begin slowly, with 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.
Heart Healthy Eating
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.
Heart-healthy eating involves consuming vegetables, fruits, whole grains, fat-free or low-fat dairy products, fish, lean meats, poultry, eggs, nuts, seeds, soy products, legumes, and vegetable oils (except coconut and palm oils). Also, it limits sodium, saturated and trans fats, added sugars, and alcohol.
For more information on healthy eating for older adults, see "Eating Well As You Get Older."
Medications are sometimes used to treat P.A.D. 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. By lowering blood cholesterol, you can decrease your chance of developing complications from P.A.D.
- lower high blood pressure with one of many available medicines
- help ease leg pain that occurs when you walk or climb stairs
- reduce the symptoms you have when walking or climbing stairs
Surgery and Other Procedures
In some people, lifestyle changes are not enough to control P.A.D. Surgery and other procedures may be needed. For example, your doctor may recommend bypass grafting surgery if blood flow in your limb is blocked or nearly blocked.
- In bypass grafting surgery, a blood vessel from another part of the body or a man-made tube is used to make a graft. This graft bypasses (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 is used 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 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 the procedure is done. Some stents are coated with medicine to help prevent blockages in the artery.
- Atherectomy (ath-eh-REK-to-mee), is a procedure that removes plaque buildup is removed from an artery. During the procedure, a catheter (thin tube) is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off the 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 do atherectomy using a special laser that dissolves the blockage.