PAD does most of its damage during its "silent" stage, before the person is aware of having it. Even so, most doctors don't favour routine screening to find silent PAD, as it would cause many patients to undergo unnecessary invasive tests. However, people with health problems or lifestyles that could lead to PAD should be watched closely for any symptoms and then tested as needed.
If you show symptoms and are diagnosed with PAD, your doctor might recommend some lifestyle changes that can slow down its progress. This advice will include the following:
- Eat a healthy diet. Cut down on foods that contribute to high cholesterol and high blood pressure.
- Exercise. Take walks, take up gardening, or use the stairs instead of an elevator, for example. Exercise helps lower blood pressure, increases blood circulation, strengthens the arteries to improve blood flow, and can help you lose weight.
- Raise the head of your bed by four to six inches. This can also help improve blood flow to your legs.
- Stop smoking. Most people who stop smoking see improvement in their PAD symptoms.
- Take the medications prescribed for diseases that contribute to PAD. If you take medications to treat high blood pressure, it's important to take them consistently and properly according to doctor and pharmacist instructions. For diabetics, maintaining good blood sugar control is vital in helping to ward off worsening PAD.
- Consume alcohol in moderation. Limit your alcohol consumption to no more than 2 drinks per day for men and no more than 1 drink per day for women.
It's crucial to slow down the progress of PAD in order to limit its complications. If your PAD continues and you need treatment, there are a few options, including medications and surgical procedures.
Medications used to treat PAD include acetylsalicylic acid (ASA)* and clopidogrel. These are blood thinners which help prevent PAD from worsening and also protect against heart attacks and strokes. When arteries are blocked suddenly, it is usually because of a blood clot – in this case, intravenous blood thinners such as heparin can help improve blood flow in a hospital setting. Other medications such as pentoxifylline may make it easier for oxygen to get to the muscles.
An angioplasty can reopen blocked areas in the blood vessels. Your doctor inserts a catheter (a small tube) into the affected artery and inflates and deflates a small balloon repeatedly to widen the plaque. Angioplasty can only be done if the artery hasn't yet hardened. The blockage also has to be over just a small area of the artery and there can't be too many blocked areas along the artery. During an angioplasty, you don't have to undergo general anesthesia, and so the hospital stay is about a day. Medications such as heparin or acetylsalicylic acid (ASA) are given after the procedure to prevent blood clots from forming.
A stent or a small metal frame can be inserted into the artery in order to support the artery walls after an angioplasty.
Bypass surgery might be necessary if other treatments don't work. The surgeon takes a bypass graft – a tube made of a synthetic material or a vein from another part of the body – and joins it to the artery above and below the obstruction. Another approach is to remove the blocked or narrowed section and insert a graft in its place. Sometimes, if the affected area is small enough, the doctor might be able to cut the clot out and save the artery.
PAD can cause severe complications in the legs and feet. Because there's less blood flowing to those parts of the body, the muscles and skin won't get the nutrients they need. A cut, scrape, blister, or any other type of damage to the skin may have a harder time healing. For this reason, it's very important to take extra care of your feet if you have PAD.
Here is some advice to identify and prevent PAD.
- Look at your feet every day, especially around the time of a bath or shower.
- Don't walk barefoot; it may cause small cuts or scrapes and promote infection in cuts that may already be present.
- Use mild soap to wash your feet.
- Dry your feet thoroughly after washing and don't use skin creams unless your doctor recommends them. Damp skin can break down easily and moisture can trigger bacterial growth, causing an infection.
- Cut your toenails very carefully and straight across. You want to avoid in-grown toenails.
- Wear comfortable shoes and watch carefully for blisters when you wear new shoes. If you notice any cuts, blisters, or other problems, monitor them closely. Ulcers should be covered with clean, dry dressings.
Be sure to contact your doctor if the cuts or ulcers don't seem to be healing, get redder or bigger, change colour, or develop a foul odour. Your doctor might prescribe an antibiotic in the form of an ointment or a pill. It can take weeks or months for the antibiotics to cure an infected ulcer.
In rare cases, if a leg or foot infection is severe or gangrene develops, amputation may be needed. But this is a last resort – most often, prompt and appropriate treatment is enough to prevent the infection from spreading.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Peripheral-Arterial-Disease