Peripheral Arterial Disease: What Are Your Treatment Options?

By Russell Becker, DO, Vascular Surgeon

Peripheral artery disease affects 8.5 million Americans. Peripheral artery disease (PAD) is caused by plaque buildup, known as atherosclerosis. The arteries can become damaged by smoking, high cholesterol, high blood pressure, and insulin resistance (high blood sugar). When this damage occurs, the body begins a healing and regenerative mechanism that allows plaque to act as a bandage over the damaged arterial walls. This is dangerous for multiple reasons, but the two most detrimental are that the plaque can break off, causing a blood clot to form, leading to strokes or embolisms. And the other issue is narrowing of the artery, which blocks blood flow in the legs, arms, brain, and heart. These issues are often linked to unhealthy lifestyles, and PAD can also lead to other complications and comorbidities.

Although PAD can happen to anyone, the most common factors that put you at risk are family history, smoking, being overweight, and a sedentary lifestyle.

Do You Have PAD?
Some of the common symptoms are pain in the leg or calf while walking. This is known as claudication, and it usually subsides once a person rests for a period of time. Other symptoms are a weak pulse in the ankle or foot, hair loss on the legs and feet, burning or tingling in extremities, swelling of calves, dry skin, dark veins, ulcers on legs or feet, and shortness of breath

Individuals with arterial disease due to atherosclerosis (plaque buildup in the arteries) often have peripheral vascular disease (PVD). Other blood vessel conditions like DVT’s (Deep Vein Thrombosis) varicose veins, pulmonary embolisms, and venous insufficiency are interrelated.

Maintaining a healthy diet is critical to keeping your lipid levels in proper balance, coordinately it will assist in supporting the vascular structures through nutrient and antioxidant-dense foods. Dr. Becker, of The Vascular Center of Naples, typically, recommends a low-fat diet full of healthy fruits, vegetables, and lean protein. Preventing atherosclerosis, or the hardening of the arteries due to plaque buildup can be achieved through medications as well. However, if the blockage from PAD is severe and life-threatening, a medical procedure will be necessary to open and repair the artery to allow blood to flow normally again.

Conservative Treatment Options
Healthy Lifestyle Changes
Changing ones diet, incorporating exercise and quitting smoking can help heal the body, and area especially important to incorporate after having a procedure.

Medications
These include, antiplatelet or anticlotting agents blood thinners, cholesterol-lowering drugs, blood pressure medications, and medications that increase blood supply to the extremities.

Procedures for PAD
Peripheral Vascular Stent
A small mesh tube may be placed in the artery during angioplasty. A stent helps keep the artery open after angioplasty is done. Some stents are coated with medicine to help prevent blockages in the artery.1

Angioplasty
A catheter (thin tube) with a balloon at the tip is inserted into a blocked artery. The balloon is then inflated, which pushes plaque outward against the artery wall. This widens the artery and restores blood flow.1

Atherectomy
is a procedure that removes plaque buildup from an artery. During the procedure, a catheter is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off plaque. The bits of plaque are removed from the body through the catheter or washed away in the bloodstream (if they’re small enough). Doctors also can perform atherectomy using a special laser that dissolves the blockage.1

Bypass Grafting
A blood vessel from another part of your body or a synthetic tube to make a graft is used as a graft. It bypasses the blocked part of the artery. The bypass allows blood to flow around the blockage. This surgery doesn’t cure PAD, but it may increase blood flow to the affected limb or area.1

Worst-Case May Require Amputation
An advanced case of peripheral arterial disease or PAD that causes a build-up of plaque in the artery wall and leads to the blockage of blood flow to a limb or extremity. If you have both PAD and diabetes, you are at a particularly high risk for requiring an amputation.2

Because the veins and arteries balance each other out, when an individual is experiencing chronic symptoms it’s critical to see a physician. If the veins are damaged, it’s not unusual that the arteries are not pumping blood efficiently either. PAD must be treated to prevent further damage to your circulatory system and your overall health. If you or someone you know is experiencing any venous or arterial issues, please contact your physician immediately.

Russell Becker, DO, Vascular Surgeon
Dr. Becker received his fellowship training in vascular and endovascular surgery at Wayne State University in Detroit. He is board-certified by the American Osteopathic Board

of Surgery, he’s a fellow of the American College of Osteopathic Surgeons, and he retains active memberships with the Society for Vascular Surgery and the American Association for Vascular Surgery.

Dr. Becker has experience and interest in all areas of vascular and endovascular surgery, including treatment of conditions like carotid artery disease, hemodialysis access creation and maintenance, and diseases of the veins.

Beyond performing surgery, Dr. Becker is a well published author of vascular surgery literature. He has previously served as an investigator in numerous new and developing clinical device trials and has been a part of the clinical faculty in vascular surgery at Michigan State University College of Human Medicine in East Lansing, Michigan.

VASCULAR CENTER OF NAPLES
WE’VE MOVED—OUR NEW LOCATION IS:
1875 Veterans Park Drive, Suite 2203
Naples, FL 34109
239-431-5884
www.vascularcenternaples.com

Sources:
1. https://www.nhlbi.nih.gov/health-topics/peripheral-artery-disease
2. https://vascular.org/patient-resources/vascular-treatments/amputation