What are my treatment options for Peripheral Vascular Disease?
Treatment depends upon the stage of the disease itself and focuses on controlling symptoms and slowing progression of the disease.
Lifestyle modifications would include quitting smoking, trying to maintain a healthier weight, and getting regular exercise such as walking at least 30 minutes, 3 times a week. Also, it is very important to control other risk factors by taking the appropriate prescribed medications to control blood pressure, cholesterol, and diabetes.
Medications prescribed by your vascular surgeon may include:
- Trental or Pletal: these can help your blood flow easier through narrowed areas in your arteries, so they may help you walk longer distances without pain
- Aspirin or Plavix: these make your platelets less sticky, which lowers your risk of blood clots
- Statin drugs: these will help keep your cholesterol levels better controlled, preventing further plaque buildup in your arteries
In severe cases of peripheral vascular disease, lifestyle modifications and medications may not be enough to help with symptoms. In this instance, the vascular surgeon will determine the best surgical or minimally invasive treatment that is best for you. This will depend on your overall health, presence of other conditions, and the location and extent of blockages.
- Angioplasty, Stenting, and Atherectomy: This is a minimally invasive procedure that involves inserting a long, thin flexible tube called a catheter through a small puncture over an artery in your arm or groin. Under x-ray guidance, this catheter is directed towards the blockage in the leg. A special balloon at the end of the catheter is deployed and deflated several times in order to compress the plaque against the walls of the artery. This widens the opening of the blood vessel, so blood is able to flow freely through it. In some instances, a mesh-like metal tube called a stent may be placed within the artery to keep it open. A device may also be used that cleans out the inner lining of the artery, removing the plaque by shaving or vaporizing it away, which is called atherectomy. These procedures can be performed outpatient, with only a short 4-hour recovery period before the patient can go home.
- Bypass surgery: Depending on the area of the blockage, incisions are made either into the leg, groin, or arm. The surgeon will use either a synthetic cylinder like tube called a graft or one of your own veins to reroute your blood flow around the blockage. The vein or graft is sewn above and below the area that is blocked, restoring blood flow to the tissues. This procedure requires a hospital stay of up to 5 days.
- Endarterectomy: An incision is made into your leg or arm, depending upon the area of the blockage, and the plaque is removed from the inner lining of the artery. This opens the artery again, restoring blood flow to the leg. The effectiveness of this procedure depends upon the location and extent of the blockage. Hospital stay is about 3-5 days.