Peripheral artery disease (PAD) occurs when there is narrowing or blockages in the peripheral arteries, usually the legs. In the early stages there may be no symptoms, but as the problem progresses, there is a significant risk of lost blood flow to the extremities. There are several ways the problem can be managed in the early stages and treated with surgical interventions, if serious complications develop.
Slowing Disease Progression
When PAD is identified in the earlier stages, it is usually the result of symptoms, such as leg pains that are alleviated after periods of rest or one extremity that is colder than the other. If there is blood flow to the extremity that is not significantly compromised, working on slowing the progression may be helpful. People who develop PAD often have risk factors, such as diabetes or high cholesterol. Working with your doctor to find a treatment that reduces the impact of chronic disease is the first approach. Additionally, eating a low-fat and low-cholesterol diet may reduce the chances of additional plaque buildups in the vessels. Routine exercise in people with PAD may improve blood flow to the extremities. Making the effort to walk as long as possible, with periods of rest, can help you balance any exercise-related leg pain with the goal of improving blood flow through exercise.
Unblocking And Bypassing Vessels
Much like blockages in the coronary arteries, vessels in the legs can be unblocked with angioplasty. If the vessel is accessible with the use of imaging guidance, a surgeon can send a catheter to the site of the blockage and use a balloon to open the blood vessel. Once the vessel is open a stent may be inserted so the vessel remains open. Sometimes the blockage cannot be accessed via angioplasty and an open surgery might be used to bypass the blockage. During a bypass, a blood vessel is harvest from elsewhere in the body, possibly the other leg, and grafted onto the affected blood vessel. The harvested blood vessel is grafted in a way that it allows blood flow to bypass the blockage, thereby restoring blood flow.
Addressing Ulcerated Limbs
In severe cases of PAD, the limb may become ulcerated as the tissue breaks down because of decreased blood flow. If the problem can be caught early, vascular surgery to unblock or bypass the affected blood vessel can be used combined with wound management. Since PAD and other conditions, such as diabetes, can compromise wound healing, it can be challenging to avoid infections that progress rapidly. Sometimes the skin ulcers progress and become gangrene and necrotic. When the dying tissue and infection is significant or the problem is progressing quickly, it may be necessary to amputate. The amount of amputation necessary will be contingent on where viable, uninfected tissue remains.
Reducing the risk factors associated with PAD will give you the best chance at slowing disease progression. Once blockages substantially reduce blood flow, restoring blood flow before permanent damage occurs may be the only way to preserve the affected limb.