Treating Peripheral Artery Disease

Beth Kassanoff, M.D. | Sep 14th 2016 Oct 7th 2016

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The problem

Leg pain—in both women and men—could signal the presence of peripheral artery disease (PAD), a cardiovascular disorder characterized by insufficient blood flow to the legs. Even scarier: PAD is often symptomless and routinely goes underdiagnosed and untreated.

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The symptoms

PAD is caused by the buildup of plaque in arteries that supply blood to the legs. It mostly affects the legs but can sometimes appear in the arms. The most common symptom is painful muscle cramping in the legs during physical activity, usually walking.

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Who’s affected

Once thought to be a mostly male disease, PAD actually affects as many women as it does men. It’s most common among minorities, especially African-American women. African-Americans are more than twice as likely as whites to suffer from PAD.

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How it’s diagnosed

A doctor will compare the blood pressure in your ankle and arm. This ratio is called the ankle-brachial index (ABI) score; lower pressure in the ankle than in the arm indicates blocked leg arteries.

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What you can do

Lifestyle measures can go a long way in helping to treat peripheral artery disease. Get regular exercise, stop smoking, and eat a heart-healthy diet, especially if your cholesterol or blood pressure needs lowering. Walk, but rest when you need to. Regularly inspect your feet for injury.

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Medication

In many cases, doctors prescribe drugs. For some patients, cilostazol (Pletal) can increase the distance they walk before symptoms occur. Statins have also been shown to increase walking distance, and ACE inhibitors, beta-blockers, statins, and antiplatelet agents such as clopidogrel and low-dose aspirin all reduce cardiovascular risks.

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Blood pressure and cholesterol control

Your doctor may ask that you take steps to lower your blood pressure and cholesterol by eating healthier, exercising more, and possibly by taking medication.

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Other interventions

If symptoms persist, you may want to consider:

• Angioplasty, where a surgeon snakes a balloon-tipped catheter through a puncture in the groin into the diseased artery.

• Leg bypass surgery, which can prevent amputation if an artery is extensively clogged.

• Thrombolytic therapy, where your doctor can inject a blood clot with a dissolving substance.