Peripheral arterial disease (PAD) cannot be cured. For most people, the combination of lifestyle change and medication will reduce both the symptoms and the risk of worsening of PAD.
Healthy living
The two most important things are increasing physical activity and stopping smoking if you smoke.
 |
Stopping smoking Smoking any form of tobacco (cigarettes, cigars, pipes, shisha) as well as chewing tobacco causes narrowing of blood vessels. Smoking is especially bad if you have PAD because:
Stopping smoking, even if you have smoked for many years, will have immediate benefits on your health and reduce the risk of all type of CVD (angina, heart attacks, strokes and PAD). |
 |
Move more Increasing your physical activity makes a big difference in reducing how bad the symptoms of PAD are as well as how often those symptoms happen. The benefits of exercise include:
Your healthcare team may be able to offer you a supervised exercise programme. This usually involves walking - see this resource for more information. It is also vital to continue regular physical activity, ideally daily, after any programme otherwise the benefits will be lost. |
 |
Healthy eating Eating a healthy diet and being careful about alcohol intake can also reduce the risk of all form of CVD (angina, heart attacks, strokes and PAD) There are some simple things you can do to make what you eat day to day healthier:
|
 |
Alcohol Alcohol can contribute to narrowing of blood vessels by causing high blood pressure. Although there is a feeling that a small amount of alcohol is beneficial, the evidence for this is not clear. If you do choose to drink alcohol the guidelines are:
|
Looking after your feet
There are some simple things you can do to reduce the risk of breaks in the skin and ulcers in the feet.
- Choose comfortable shoes that fit well. If you buy new shoes, have a look at your feet after you have been wearing them for an hour or so to make sure that they are not rubbing.
- Don’t walk around barefoot.
- Wash and dry your feet carefully every day.
- Avoid very hot or very cold temperature such as a very hot bath.
- Be careful when you cut your toenails. If you are struggling, you may wish to see a podiatrist or chiropodist. It is important to tell them about your PAD.
- If you develop a break in the skin or an ulcer, arrange to see your healthcare team as soon as possible.
Medication
These can include:
If you have PAD, your doctor will suggest that you take medication to reduce the risk of clots forming. The commonest medications used are clopidogrel and aspirin.
Naftidrofuryl oxalate (Praxilene) is a medication that can help widen the arteries by making them relax. Although it can help with the symptoms for some people, it does not reduce the amount of fatty deposits.
Controlling blood sugars reduces the risk of PAD happening in the first place as well as helping to heal ulcers due to PAD. Diet and physical activity can help control diabetes and losing weight can even put diabetes into remission. However, some people do need medication to keep their blood sugar controlled.
High blood pressure can often be controlled by making changes to your lifestyle, although many people also need medication. Your healthcare team can advise on your blood pressure goal and treatment.
Eating a healthy diet, maintaining a healthy weight and doing physical activity can all help bring cholesterol down. In addition, people at high risk are often advised to take cholesterol tablets (such as statins). Your healthcare team will measure your cholesterol and advise on treatment.
Specialised Treatments
If symptoms worsen or do not respond to lifestyle change and medication and the narrowing in an artery is very severe, then the vascular surgeon may suggest angioplasty or a bypass operation.
Angioplasty and Stenting
Angioplasty is when a balloon is used to open up a narrowed artery. A thin flexible tube is put into a blood vessel and threaded to the narrowed artery. Angioplasties are done under local anaesthetic, meaning that people are awake but have a medicine injected into the skin to make it numb. Once the thin flexible tube is in the right place, a balloon is inflated inside the artery, squashing the fatty material and widening the narrowing. Very often a short wire mesh tube called a stent is then left in to keep the artery open.
Bypass surgery
Bypass surgery is an operation to divert blood around a narrowing or blockage in an artery. The operation is done under general anaesthetic, so people having this are completely asleep. The surgeon will take a blood vessel from another part of the body and attach it above and below the narrowing or blockage. The blood vessel used is called the graft. This is only usually considered for very severe symptoms and when there is a long narrowing or blockage in the artery.
