PAD Treatments in Louisville, KY
Only a vascular specialist trained all aspects of Peripheral Artery Disease (PAD) care can educate you and offer you all potential methods to treat your disease.
If your peripheral artery disease is detected early, you can make lifestyle changes to help you manage your disease. Lifestyle changes that help you manage your leg artery disease include:
- Managing diabetes by maintaining healthy blood sugar levels
- Lowering high cholesterol
- Lowering high blood pressure
- Quitting smoking
- Eating foods low in saturated fats and calories
- Maintaining your ideal body weight
- Exercising and walking regularly, for instance walking at least 30 minutes 3 times each week
Your physician may also recommend medication to treat conditions that worsen or complicate leg artery disease. These medications may include cholesterol-lowering drugs (statins) or blood pressure-lowering medications. You may also need to take medications that reduce blood clotting to minimize the chances of clots blocking your narrowed arteries.
If you do not have a disqualifying medical condition, such as heart failure, your physician may also prescribe cilostazol (Pletal), which can improve the distance you are able to walk without discomfort or pain. Other drugs your physician may prescribe include aspirin and clopidogrel (Plavix), either of which can decrease your chances of developing blood clots.
Exercising and walking regularly, for instance walking at least 30 minutes 3 times each week, may help improve your symptoms.
In more severe cases of leg peripheral disease, lifestyle changes and medication may not be enough to improve your symptoms. Also, if your disease has advanced, your physician may recommend surgical or minimally invasive treatments. The choice of the treatment depends upon the pattern and extent of the blockages as well as other factors, such as your general health and the presence of other medical conditions. Your vascular surgeon will help you determine which is the best option for your particular situation. Sometimes a combination of the various tools available may be required for the most favorable results.
Angioplasty and stenting
In some cases of PAD, your physician may recommend angioplasty and stenting. This procedure is considered to be minimally invasive in comparison to open surgery. It is most effective for more localized blockages in the larger arteries. In an angioplasty, your physician inserts a long, thin, flexible tube called a catheter into a small puncture over an artery in your arm or groin. The catheter is guided through your arteries to the blocked area. Once in place, a special balloon, which is attached to the catheter, is inflated and deflated several times. The balloon pushes the plaque in your artery against your artery walls, widening the vessel. In some circumstances, your vascular surgeon may then place a tiny mesh-metal tube, called a stent, into the narrowed area of your artery to keep it open. The stent remains permanently in your artery. After this procedure, blood flows more freely through your artery. Other devices, such as atherectomy catheters, are currently being developed and are under evaluation to determine their effectiveness.
Bypass surgery creates a detour around a narrowed, or blocked, section of a leg artery. To create this bypass, your vascular surgeon uses one of your veins or a tube made from man-made materials. Your vascular surgeon attaches the bypass above and below the area that is blocked. This creates a new path for your blood to flow to your leg tissues and is particularly effective for extensive artery blockages.
An endarterectomy is a way for your surgeon to remove the plaque from your artery. To perform an endarterectomy, your vascular surgeon makes an incision in your leg and removes the plaque contained in the inner lining of the diseased artery. This leaves a wide-open artery and restores blood flow through your leg artery. The effectiveness of this method depends upon the particular location and extent of the arterial blockage.
In extreme cases, especially if your leg has gangrene and is not salvageable, your surgeon may recommend amputating your lower leg or foot. Amputation is a treatment of last resort. Vascular surgeons usually only perform it when the circulation in your leg is severely reduced and cannot be improved by the methods discussed already. More than 90 percent of patients with gangrene who are seen by vascular specialists can avoid amputation or have it limited to a small portion of the foot or toes.