Peripheral artery disease (PAD)

Making lifestyle changes can make a big difference in the symptoms and progression of peripheral artery disease. Your doctor may recommend:

• Improve your diet: Aim for a diet low in salt, sugar and processed foods and rich in vegetables, whole grains, nuts and seeds, fish and poultry instead of red meat, and low-fat dairy.
• Manage diabetes: If you have diabetes, it’s important to control your blood sugar. Talk with your health team about the best steps to take.
• Stay or become active: Activity can be challenging with peripheral artery disease, because walking can be painful. Your doctor may recommend a rehabilitation program that can help you more comfortably increase your activity.
• Stop smoking: You can stop smoking with help from our compassionate, effective program, Penn Stop.

Your doctor may prescribe medication for peripheral artery disease. These medications can reduce your chance of developing complications from PAD. They can also reduce your risk of other problems, such as heart attack and stroke.

Your doctor may prescribe medicine to:

• Prevent blood clots: medications such as aspirin, clopidogrel (Plavix), dabigatran (Pradaxa) or warfarin (Coumadin) reduce the risk of clots.
• Lower cholesterol: statins and other drugs can reduce blood cholesterol levels.
• Reduce high blood pressure: drugs such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers can lower blood pressure
• Improve your walking distance: a medication called cilostazol can help improve walking distance if you have claudication.

For some people, medicine and lifestyle changes don’t resolve symptoms of peripheral artery disease. Penn Medicine vascular surgeons, interventional cardiologists and interventional radiologists have expertise in procedures to treat PAD. We offer advanced minimally invasive (endovascular) and surgical procedures including:

• Angioplasty and stent placement: a physician inserts a catheter through a tiny incision and threads a miniature balloon to the blockage. Inflating the balloon presses the artery open. We may place one or more stents (small mesh tubes) to hold the artery open. Sometimes, we use drug-eluting balloons or stents. These devices release medicine to help keep the artery open.
• Atherectomy: in a procedure similar to angioplasty and stenting, the physician inserts a catheter to the point of a blockage. The catheter has a tiny cutting blade that the surgeon uses to carefully cut away plaque to reopen the artery.
• Lithoplasty: this innovative technique uses a shock wave to break down calcified plaque in the arteries. Surgeons can then treat the blockage with balloons or stents, reopening the artery.
• Bypass surgery: if part of an artery is completely blocked, a surgeon can perform bypass surgery. The surgeon uses a vein from another part of your body, or an artificial vein, to graft (attach) above and below the blockage to reroute blood flow. Learn more about femoral popliteal bypass surgery.

In severe cases, peripheral artery disease can lead to critical limb ischemia (lack of blood flow to your lower leg or foot). This condition can cause nonhealing wounds that can lead to tissue death (gangrene). Our teams work to prevent amputation and limb loss through Penn Medicine Advanced Limb Preservation.