Peripheral Vascular Disease manifests with insufficient blood flow to the tissues and has the potential to cause loss of limb and even death. The latter is more common in acute limb ischemia as diagnosed by Vascular Surgeon and needs emergency intervention.
What are the risk factors for peripheral artery disease?
The risk factors for PAD include:
- Age: PAD is more common in men and women over the age of 50 years.
- Metabolic disorders: like diabetes and high cholesterol levels cause PAD
- Obesity: abdominal obesity is particularly dangerous for both men and women and associated with higher risk of cardiovascular disorders and PAD
- Kidney disease is both a consequence and a risk factor for PAD
The main goals of treatment in peripheral artery disease (PAD) is managing pain and stopping the progression of atherosclerosis. The following are the treatment options for PAD:
- Lifestyle modification:
Modification of risk factors such as smoking cessation, contribute a great deal in improving peripheral artery disease. Smoking constricts the vessels and damages the innermost layer of the arterial walls. It is, therefore, a significant risk factor for PAD. This is why smoking cessation is one of the first steps taken by the healthcare provider in managing PAD.
Exercising and using the peripheral muscles also improves the blood flow to the peripheral arteries. One of the ways to measure success in therapy is to check how far the patient can walk without pain. Talk to your healthcare provider to design an exercise regimen that works for you.
Healthy diet is another mandatory step for management of PAD. A diet lower in saturated fat helps to lower both the total cholesterol and blood pressure, thereby reducing the risk of atherosclerosis.
The following drugs are prescribed for management of PAD:
Medication for acute relief: for this purpose, the drugs commonly prescribed include cilostazol which keep the vessels dilated and increase the blood flow to the limbs. Most people with PAD use either cilostazol or pentoxifylline to manage the pain.
Cholesterol lowering medication: one of the risk factors for atherosclerosis and narrowing of blood vessels is high cholesterol. To lower the serum levels of ‘bad cholesterol’ drugs like statins and fibrates are prescribed. The goal is to bring LDL levels to less than 100 mg/dL or even lower if there are additional risk factors.
Blood pressure medication: hypertension compounds PAD, therefore, healthcare providers prescribe antihypertensives to treat this risk factor. The treatment goal is to keep the blood pressure less than 130/80 mmHg, and this helps to manage PAD and other cardiovascular disorders.
Anti-diabetic drugs: Diabetes is another risk factor for PAD, and needs a strict control to prevent ongoing damage to the vessels. Monitor your blood sugar levels (BSL) and talk to your healthcare provider about dose adjustment or additional medication if BSL is high.
Drugs to prevent clot formation: Dislodging of already formed clots—emboli, or buildup of clots overtime, both contribute to PAD. Thus, drugs like blood thinners and antiplatelets are used to prevent them. Commonly used drugs include daily aspirin or clopidogrel.
In acute cases, surgery may be necessary to provide relief. Surgical options include:
Angioplasty: involves threading a catheter through the blood vessel with a balloon on the tip of the catheter to inflate it. Once the balloon is inflated, it flattens the cholesterol plaque blocking it. This method is commonly used to reopen vessels.
Thrombolytic therapy: involves injecting a clot-dissolving drug at the exact site where the block is occurring.
- Bypass surgery: your healthcare provider like Vascular Surgeon, may create a path around the blocked vessel to make an alternate route for the blood flow.