Peripheral Artery Disease (PAD)
Medical College of Wisconsin specialists at the Heart and Vascular Center are up-to-date on the latest research findings and treatment techniques for peripheral artery disease (PAD) and all vascular disease conditions. Team members collaborate to deliver integrated care. Each treatment approach has risks and benefits, and we compare various techniques for each patient to provide the most appropriate therapy.
Treatment for PAD may involve lifestyle changes to reduce risk, treating the limb(s) to reduce disease progression, treatment to save the limb(s) and therapies to prevent the associated risk of heart attack or stroke. Some patients need a combination of therapies. In some cases, minimally invasive endovascular procedures or vascular surgery may be necessary. Non-invasive treatments for PAD, also called peripheral vascular disease (PVD), include:
Lifestyle changes: Quitting smoking, maintaining a healthy weight and getting regular exercise are all important steps to help stop the progression of PAD and relieve some of its symptoms. For some patients, this may be all that is needed to treat PAD.
Medical management: Medications may be prescribed to prevent blood clots, improve blood flow and reduce discomfort when walking. Medications may also be used to treat underlying conditions such as diabetes, high blood pressure and high cholesterol.
Minimally Invasive Endovascular ProceduresMinimally invasive endovascular procedures (catheterization procedures) treat vascular disease from inside the blood vessel. Many vascular problems that once required invasive surgery can now be treated this way. As a result, patients experience reduced hospital and recovery time, and often experience significantly less pain.
Endovascular therapy uses catheter-based procedures and specialized equipment and techniques. These procedures require only a small incision, through which a thin catheter can be inserted through the arm or groin. Using advanced imaging technology to visualize the path, physicians guide the catheter through the blockage. The blockage can then be dilated by inflating a tiny balloon. Atherectomy may also be used. This technique utilizes a catheter tipped with a specialized device to strip plaque out of the blocked artery and increase the flow of blood through the area. A stent (wire mesh tube) may be placed in reopened segments to help keep the vessel open.
Vascular SurgeryBypass surgery and endarterectomy are two surgical treatment options for PAD.
Bypass surgeryWhen PAD results in limb-threatening blockages in the legs, bypass surgery may need to be performed. This involves using a blood vessel (man-made or a natural vessel from another part of the body) and placing it around the segment of blocked vessel, creating a detour or bypass. Blood flow is redirected through the new blood vessel, bypassing the blood vessel that is damaged. In addition to the legs, bypass surgery is also performed to treat blockages in blood vessels in other parts of the body.
EndarterectomyEndarterectomy is the surgical removal of obstructions from an artery that has become narrowed or blocked by plaque. A vascular surgeon makes an incision in the artery and removes the plaque in the artery’s inner lining to restore blood flow. This procedure is most commonly done in the carotid arteries in the neck that deliver blood to the brain. It is also done to treat other arteries in the body.
Date: April 23, 2012
Online Editor(s): Richard Petre