Peripheral arterial disease (PAD) is a circulatory condition that affects the arteries outside of the heart. When PAD worsens, it can cause leg pain and problems walking. If you’re living with PAD, there are several treatment options available to you, including non surgical treatments. Keep reading to learn more about your treatment options and how to get started on finding the best treatment for you.
What is peripheral arterial disease (PAD) (also called peripheral artery disease)?
Peripheral arteries are the blood vessels that carry oxygen-rich blood from your heart to the rest of your body. Peripheral artery disease (PAD) is a condition in which these arteries become narrowed and blocked by fatty deposits called plaque. This can reduce or block the flow of blood to your arms, legs, stomach, and other organs.
The leading cause of peripheral artery disease (PAD) is atherosclerosis. Atherosclerosis is a condition in which plaque builds up inside the arteries. Plaque is made up of fat, cholesterol, calcium and other substances found in the blood.
Hardened plaque narrows the artery and reduces blood flow to that area of your body. The narrowing starves your muscles of oxygen-rich blood, causing pain.
Peripheral arterial disease sometimes goes undiagnosed because you may not have any symptoms until middle age or later when peripheral arterial disease becomes more severe.
Who gets peripheral artery disease (PAD)?
PAD is most common in people older than 50 and those who smoke or have diabetes. However, anyone can develop peripheral arterial disease (PAD).
Besides diabetes and smoking risk factors for atherosclerosis include :
- High blood pressure
- Obesity
- High cholesterol levels
Why is diabetes so bad when it comes to PAD?
Diabetes, especially if not controlled well, can cause nerve damage in the legs and feet as well as slow down healing of wounds. This makes peripheral artery disease (PAD) worse because it may be harder for you to notice that a wound is becoming infected or worsening. It also increases your chance of foot ulcers and gangrene. Gangrene is when body tissue dies due to lack of blood supply.
Why is smoking so bad when it comes to PAD?
Smoking is the leading cause of peripheral artery disease (PAD). Smoking damages the lining of your arteries and makes it easier for plaque to build up and lead to reduced blood flow. This increases your risk of atherosclerosis, heart diseases and PAD.
What are the usual symptoms of peripheral arterial disease (PAD)?
As we have seen PAD is a blood vessel disease that affects the arteries outside of the heart. When PAD worsens, the vessel narrowing can cause leg pain and problems walking.
The most common symptoms of peripheral artery disease (PAD) are:
- Leg pain, especially when you walk or exercise
- Tiredness in your legs, even after minimal activity
- Numbness or tingling in your feet or toes
- Cold feet or legs
- Sores on your feet that don’t heal properly
- Shiny skin
- Slow hair and nail growth
If you’re experiencing any of these symptoms, it’s important to see a doctor right away. Left untreated, PAD can lead to serious health complications.
How is peripheral artery disease (PAD) diagnosed?
To determine if you have peripheral artery disease your doctor will ask about your health history and perform a physical exam. During the exam he or she will check for weak pulse in your ankles and look for signs of poor circulation such as shiny skin, cold feet, or slow hair growth on toes and legs. Your doctor may also suggest other tests to diagnose PAD including.
- Ankle brachial index (ABI) test
- Pulse volume recordings
- Arteriography/angiogram
- Blood tests
- CT angiography (CTA) scan
- MRI angiography scan
Why do more and more people choose non surgical treatments over surgical treatment for peripheral artery disease (PAD)?
There are a number of reasons why people may choose non surgical over surgical treatments for peripheral artery disease (PAD).
More and more people choose to try non surgical treatments first because they want to avoid the risks and possible complications of surgery. These include infection, blood clots, and damage to nerves or other organs. Surgery also requires general anesthesia which many people find uncomfortable. Recovery periods are longer too and activities have to be stopped for an extended period of time.
Other people may choose non surgical treatments because they are not able to undergo surgery for various reasons including heart disease, or other health conditions that would make them too high risk for surgery. Some patients simply do not want any type of invasive treatment and opt instead for less aggressive methods that can help relieve their symptoms.
Non surgical treatments are often very effective at relieving symptoms of peripheral arterial disease (PAD). Many people find that they can resume their normal activities quickly after treatment.
OK. So what are the surgical treatments for peripheral artery disease (PAD)?
Surgical options are mainly:
- Bypass grafts performed by vascular surgeons
- Endarterectomy – cleaning out the material inside the artery
- Amputations performed by podiatrists and orthopedic surgeons
What is bypass surgery for peripheral arterial disease (PAD)?
A bypass graft is where a healthy section of vein or artery from another part of your body is used to create a new path for blood to flow around the blocked area. Alternatively a synthetic graft can be used.
What is an endarterectomy?
An endarterectomy is a surgical procedure which aims to remove the blockage in your artery. Endarterectomy can be performed on different parts of the body including carotid arteries, leg arteries and coronary arteries. The exact type of surgery that you will receive depends on where the plaque buildup is located in your body.
An endarterectomy may be recommended if you have no other alternative treatment options available to treat your peripheral arterial disease (PAD). During an endarterectomy, general anesthesia will be used. The vascular surgeon will open up a small incision near the affected blood vessel and remove any plaque deposits from within.
What are amputations and why do them?
An amputation is where the diseased or damaged part of the limb is removed. This usually reserved for when tissue is irreversibly damaged and in danger of becoming infected. The is generally tissue death. Gangrene is a serious medical condition that occurs when body tissue dies due to a lack of blood supply. It is life threatening and has to be treated immediately. Amputation can be part of the treatment.
These surgical treatments are major procedures that can carry risks and complications so they should only be considered after all other options have been explored.
OK. So what are the non surgical treatments for peripheral artery disease (PAD)?
Non surgical treatments for peripheral artery disease include lifestyle changes, medications, and new “pinhole” procedures that allow minaturized equipment to be places in the areas of need to provided needed treatment?
What are the lifestyle changes that could help my PAD?
There are a number of lifestyle changes you can make to help relieve symptoms of peripheral artery disease and improve blood flow. These include:
- Quitting smoking
- Eating a healthy diet
- Exercising regularly
- Maintaining a healthy weight
What are the medications that could help my PAD?
There are a number of medications your doctor may prescribe to help relieve symptoms of peripheral artery disease and improve blood flow. The medications will lower blood pressure, reduce cholesterol levels, thin the blood and dilate you arteries therefore improving flow. These medications include:
- Statins
- ACE inhibitors
- Angiotensin receptor blockers (ARBs)
- Beta-blockers
- Calcium channel blockers
- Diuretics
- Pentoxifylline decreases blood viscosity
- Cilostazol promotes vasodilation and antiplatelet activity
What is a “pinhole” procedure and how can it help my peripheral artery disease?
A pinhole procedure is a new type of treatment for peripheral arterial disease that uses miniaturized equipment to be placed in the areas of need. This allows the provider to deliver needed treatments directly to the area without having to make large incisions. This can be helpful in treating blockages and improving blood flow.
When miniaturized equipment is placed into your arteries the technique called endovascular treatment. This is a less invasive treatment option for peripheral arterial disease that has shown to be very effective in improving blood flow and relieving symptoms.
The main endovascular techniques for PAD are:
- angioplasty – using tiny balloons to push open the narrowed part of your artery
- stent placement – using a tiny cylinder to hold open the narrowed part of your artery
- atherectomy – using a tiny device to clean out the material narrowing you artery
Each of these techniques has been shown to be effective in improving blood flow and relieving symptoms. Talk with your provider to see if one of these treatments may be right for you.
What is angioplasty?
Angioplasty is a procedure that uses tiny balloons to push open the narrowed part of your artery. This is done by placing a small catheter into the blocked area and inflating the balloon. The pressure from the balloon can help to clear the blockage and improve blood flow.
Durg coated balloons may be used. These are tiny balloons that are coated with medication. When inflated, the balloon delivers the medication directly to the blockage. This can help prevent restenosis by preventing scar tissue from forming at the site of treatment.
What is stent placement?
Stents are tiny cylinders that hold open your artery when placed in a blocked area. Stents used for peripheral arterial disease treatment have shown to be effective in improving blood flow and reducing symptoms of PAD including leg pain and numbness or tingling sensation in your feet or toes. These results have been seen even after many years following procedure! You will likely need to take aspirin every day long-term; this helps reduce risk of blood clots inside stent blocking it again over time.
Like balloons stents can be drug eluting. Drug eluting means the stent is coated with medication. This can help prevent restenosis by preventing scar tissue from forming at the site of treatment.
What is atherectomy?
Atherectomy involves using a tiny device to clean out material that may be narrowing your artery. This catheter has a rotating blade that helps remove the build-up of plaque from your artery. It also has a suctioning system that removes any debris or blood clots that are present. The blockage or plaque in the blocked area is then removed from the body and blood flow is improved!
Atherectomy has been shown to be effective for improving blood flow and reducing symptoms including leg pain, numbness or tingling sensation in your feet or toes! It also reduces risk of amputation for patients who have PAD.
What are the benefits of a “pinhole” procedure?
These are non-surgical and do not require large incisions. Most procedures can be done in the office under local anesthesia. You leave with a Band-aid!
The recovery time is much shorter than surgery and allows you to return to your normal activities quickly. This means that no time off work is needed and, depending on your job requirements, some patients may even be able to go back to work immediately after treatment! Pinhole procedures do not require general anesthesia so there are none of the risks associated with it either. Some patients find they have less pain than other treatments for PAD because there aren’t any large incisions made which would need stitches or staples afterwards-they just feel sore for a day or two.
Other benefits include less risk and less complications.
So how do I find out if I am a candidate for non surgical peripheral artery disease treatments?
So there you have it: some of the basics about peripheral artery disease. Hopefully this information has helped shed some light on this condition and its effects on your body. With early intervention the serious health problems associated with peripheral artery disease can be stopped.