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Treatments

Treatment Goals

The goals for treating PAD are to:

  • Reduce symptoms
  • Improve your quality of life
  • Prevent complications

Lifestyle Changes

Treatment of PAD often includes making long-lasting lifestyle changes including:

  • Quitting smoking. For patients who continue to smoke this is the most important step and frequently significantly reduces symptoms.
  • Lowering blood pressure
  • Lowering cholesterol
  • Treating diabetes
  • Increasing physical activity
  • Eating a healthy diet

Medications

Your physician may also prescribe medications to treat conditions that worsen or complicate PAD that may include:

  • Cholesterol-lowering drugs
  • Blood pressure medications
  • Medications to control blood sugar if you have diabetes
  • Aspirin to reduce the possibility of blood clots
  • Drugs to help relieve symptoms may also be prescribed. These may include cilostazol (Pletal), a drug that increases blood flow to the limbs.

Foot and Skin Care

You may also be urged to take better care of your feet. If you have PAD, particularly if you have diabetes, you may be at risk for developing sores on your lower legs and feet. Poor blood circulation can interfere with proper healing, increasing the risk of infection. To prevent this, you should:

  • Shower to wash your feet daily
  • Moisturize your feet daily to prevent cracks that can lead to infection
  • Wear shoes that fit well and socks that are thick and dry
  • Any fungal infections, such as athlete's foot, should be treated promptly
  • Avoid walking barefoot and soaking your feet

Angioplasty and Stenting

If lifestyle changes and/or medications aren't enough to improve symptoms that are particularly severe or if there is evidence of risk of injury to a limb, your doctor may recommend angioplasty, or angioplasty with stenting. This is a minimally invasive procedure compared to open surgery:

  • Your doctor inserts a long, thin tube or catheter into a small puncture over an artery in your arm or groin.
  • The catheter, which has a balloon at its tip, is guided through your artery to the blocked area.
  • Once in place, the balloon is inflated and pushes the plaque in your artery against the artery walls, making the passageway wider.
  • In some cases, your doctor may place a tiny mesh-like tube, called a stent, into the narrowed area of your artery, keeping it open.
  • The stent remains there permanently.
  • This procedure requires a night in the hospital.

Bypass Surgery

Bypass surgery may be recommended depending on the severity of the blockage in your artery:

  • A vein from another part of your body is taken to create a bypass around the blocked area.
  • A graft using man-made materials may also be used.
  • Your surgeon attaches the bypass graft above and below the area that is blocked, creating a new path for the blood to flow to your leg tissues.
  • This procedure requires general anesthesia and a three to five day hospital stay.

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-8800

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