We’ve talked about what Peripheral Arterial Disease is in previous columns. Now, let’s look at some possible operative treatment options for PAD. When medical management alone has failed to improve symptoms, the possible treatment options include the following:
1.) Endovascular treatment with balloon angioplasty: In this procedure, a catheter is threaded through a blood vessel to the affected artery. There, a small balloon on the tip of the catheter is inflated to flatten the plaque into the artery wall and reopen the narrowing (stenosis) or blockage (occlusion) in the artery while stretching the artery. A wire is used to cross the blockage, and various modalities may be employed (either alone or in combination) like atherectomy (a procedure that utilizes a catheter with a sharp blade on the end to remove plaque from a blood vessel) suction thrombectomy (using a catheter to suck out fresh clot), thrombolytic infusion (clot-busting medication given at the site of the clot). No cuts are made during this procedure, and it’s typically done in a cardiac catheterization lab. Your doctor may also insert a mesh tube (stent) in the artery to help keep it open. This is the same procedure doctors use to open heart arteries.
2.) Surgical procedures (for example femoral popliteal bypass, femoral endarterectomy/patch angioplasty): Your doctor may create a path around the blocked artery using either a blood vessel from another part of your body or a synthetic vessel. This technique allows blood to bypass the blocked artery. This is typically performed in an operating room in the hospital.
3.) Hybrid procedures: (combination of endovascular and surgical procedures)
4.) Supervised exercise program: Your doctor likely will prescribe a supervised exercise training program to increase the distance you can walk pain-free. Regular exercise improves symptoms of PAD in a number of ways, including helping your body use oxygen more efficiently. This is useful in combination with the above procedures and only if you suffer from claudication alone.