Home Treatments

Treatments

Learn About PAD Treatments

Managing your PAD means taking action in two areas:

Manage Your Risk Factors

Recommended for ALL:

Make Lifestyle Changes

Lower Cardiovascular Risk

Regardless of how you choose to manage your PAD symptoms, it is recommended to proactively manage your risk factors.

Manage Your Symptoms

Treatment Options for PAD Pain Relief:

Medical Interventions:

  • Non-invasive treatment
  • Invasive treatment
  • Combination of non-invasive and invasive treatments

The PAD treatment plan you pursue will depend on the severity of your symptoms, the condition of your arteries, the location of your blockage(s), and your overall health.

Lifestyle Changes

Recommended for ALL patients with PAD

Scientific studies show strong evidence that making these lifestyle changes can improve or slow the progression of peripheral artery disease.

To achieve the best outcomes:

LIFESTYLE CHANGES

  • Quit smoking — Smoking is a major risk factor for PAD. Goal is to be tobacco free and to avoid second-hand smoke. At every visit with their provider, patients should be advised to quit smoking and offered a plan to support smoking cessation (e.g. nicotine replacement therapy, medications, smoking cessation program).

 

  • Control diabetes — Diabetes increases the risk for progression of PAD. The American Diabetes Association recommends an A1C target goal of < 7.0%.

 

  • Control blood pressure — Hypertension (blood pressure ≥ 130/80 mmHg) is associated with the development and progression of PAD, as well as increasing the risk of cardiovascular events like stroke and heart attack.

 

  • Eat a heart-healthy diet — Eat a diet that contains lots of vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts. Limit intake of sodium, sugar-sweetened beverages and red meats.

 

  • Maintain an active lifestyle — Move more, sit less. Set a goal for at least 150 minutes of moderate intensity activity each week. Participating in a supervised exercise program 3 times a week for a minimum of 30-45 minutes can ease leg claudication symptoms. Before you engage in exercise, talk to your doctor about what amount of exercise is right and safe for you.

 

  • Practice healthy foot care — Inspect bare feet every day and seek health care early for red spots, cuts, swelling and blisters. Ask for help or use a mirror if you can’t see the bottoms of your feet. Your provider should check your feet at least once a year.

 

Strong evidence | Benefit outweighs risk

Consult this document for a complete list of evidence.

Cardiovascular Risk Management

Recommended for ALL patients with PAD

PAD is a form of cardiovascular disease, which means it increases your risk of suffering a heart attack or stroke. Scientific studies show strong evidence that taking cardiovascular medications can lower your risk of heart attack or stroke.

To reduce your risk of heart attack or stroke, your provider may prescribe:

Cardiovascular Medications

  • Statins to lower cholesterol
  • Antiplatelets (like aspirin) to lower risk of clotting

 

Strong evidence | Benefit outweighs risk

80% of PAD patients receive prescriptions for blood thinners and cholesterol lowering medications.

Ask your provider about ways to manage your cardiovascular risk.

SOURCE: PORTRAIT Study 2017

Treatment Options for Relief of Leg Pain

To manage PAD leg pain, or claudication, generally it is recommended to try non-invasive treatments first, before trying invasive options. Your treatment plan may include a combination of these options, and the treatments you choose may change throughout your lifetime. To manage your symptoms, there are two treatment pathways:

Non-Invasive Treatments

(does not break the skin or require an incision)

SUPERVISED EXERCISE THERAPY

  • Recommend walking at least 3 times per week for 30-45 min. each session for at least 12 weeks
  • Supervised programs are recommended over home-based exercise
  • Supervised exercise therapy is approved and covered by Centers for Medicare and Medicaid Services (CMS). Your provider can prescribe this program.


Strong evidence | Benefit outweighs risk

 

CLAUDICATION MEDICATIONS

  • Medications that can reduce leg pain and discomfort

 

Strong evidence for cilostazol (Pletal) | Benefit outweighs risk

Evidence of harm for pentoxifylline (Trental) | Risk greater than benefit

Invasive Treatments

(requires an incision)

ANGIOPLASTY

  • A small balloon is inflated inside the artery to improve blood flow

STENTING

  • Uses angioplasty to insert a stent (small tube)
    to hold the artery open

LEG BYPASS SURGERY

  • Uses a vein from another part of the body or a graft to direct blood flow around the blockage

 

Benefit or risk of each procedure depends on the severity of your symptoms, the condition of your arteries, the location of your blockage(s), and your overall health. Talk with your provider to understand the risks and benefits.

WHAT HAPPENS IF I DO NOTHING?

If you take no action to manage your PAD:

  • Your symptoms may get worse
  • Your risk of experiencing a heart attack or stroke may increase

Talk to your provider about what this could mean for you.

In Step , watch Patient Stories and Provider Perspectives videos.

In Step , use the Decision Aid to compare the Pros and Cons of each treatment option.

netherlands

In the Netherlands, 70% of PAD patients receive a referral from their doctor for supervised exercise therapy.

usa

In the U.S., supervised exercise therapy is recommended to less than 2% of PAD patients.

Ask your provider about the benefits of supervised exercise therapy.

SOURCE: PORTRAIT Study 2017

More questions?

  • For a visual overview of PAD, visit the American Heart Association website.
  • If you want to learn more about PAD, consult these resources for additional PAD information.
  • If you are not sure whether you have PAD, talk to your doctor. There is a simple test to check the blood flow in your leg arteries, called the Ankle-Brachial Index.
  • Talk to your doctor if you have any concerns about symptoms, risk factors, or worsening of symptoms related to your PAD.

Follow these steps to learn about PAD