Treatment Includes Both Surgical and Non-Surgical Options
Non-Surgical Treatments for PAD
All patients with peripheral artery disease are treated using risk factor management, which depending on symptoms and blockage could include:
- Aspirin regimen
- Improved diet
- Smoking cessation
- Controlling high blood pressure, high cholesterol or diabetes
All patients also get an exercise program. Typically, peripheral arterial disease causes leg cramping when walking, although there is no pain while at rest. This leg pain is called claudication. Claudication lowers your quality of life because you can’t do many things, such as working, going to the store and golfing. Our walking program will help you increase distance before you get pain, with an ultimate goal of eliminating the pain entirely.
If exercise therapy is not successful in treating your blockage, we turn to revascularization therapies, which include balloons, stents or bypass surgery. For patients with critical limb ischemia – an advanced form of peripheral arterial disease where patients are getting no blood flow in their feet and are in danger of losing a leg – we offer same day, emergency treatment.
Surgery for Patients with Severe PAD Symptoms and Complications
Surgery is reserved for patients who have the most severe symptoms and complications. In the most extreme cases, when a leg has gangrene (when body tissue dies) and cannot be saved, amputation may be recommended. This is, however, a last resort and in many cases even when gangrene is present, amputation can be avoided. The following are surgical procedures that may be used to treat peripheral arterial disease:
Balloon Angioplasty/Stenting - a procedure in which your vascular surgeon inserts a balloon catheter into a narrowed portion of an artery. Expanding the balloon compresses the plaque against the artery wall and reduces the blockage. The balloon and catheter are then removed.. The stretching of the artery greatly improves blood flow through the artery. Often a metal device called a stent is left in the artery to improve chances that the blood vessel will stay open.
Bypass Grafting - a surgical procedure to redirect blood flow around an area of blockage. The procedure creates an alternate channel for blood flow, bypassing an obstructed or damaged vessel. The graft may come from a healthy section of the patient's own vein, or a synthetic material, such as Dacron™ may be used.
Cryoplasty, or cryo-balloon angioplasty - a procedure similar to angioplasty in which a vascular surgeon inserts a balloon catheter into a blocked artery to repair an obstruction within the vessel. Once the balloon catheter reaches the site of the blockage, it is filled with liquid nitrous oxide, which immediately evaporates into a gas, causing the balloon to inflate and freeze the surrounding tissue, promoting the dilation or opening of the artery while minimizing the potential for growth of new scar tissue, and reduces the likelihood that the blockage in the treated location will reoccur.
Percutaneous or Laser Atherectomy - a procedure in which a vascular surgeon inserts a specialized catheter into a blocked artery to remove a buildup of atherosclerotic plaque from within the vessel. The catheter contains a sharp rotating blade, grinding bit, or laser filament, as well as a collection system that permits the surgeon to remove the plaque from the wall of the vessel and collect or suction any resulting debris.
Promising New Treatment Options
In addition to these surgical and non-surgical treatment options, the University of Michigan also has opportunities for patients to participate in clinical research studies. Learn more about these PAD-related clinical research studies.
One ongoing study is called the MultiGeneAngio trial. The University of Michigan and VA Ann Arbor Health Systems are two of only three locations where patients with severe PAD are being treated with an experimental new gene therapy treatment called MultiGeneAngio as a way to help the body grow new blood vessels in the blocked area.
The MultiGeneAngio trial takes cells from a vein in the patient's arm, adds in new genes that encourage the growth of blood vessels, and then injects the cells into the blocked artery using a minimally invasive technique. Comprehensive pre-clinical studies showed that production and administration of MultiGeneAngio was safe, as no apparent drug-related adverse events have been observed. This trial is now closed, but additional follow-up data will continue to be collected to help evaluate the safety and efficacy of MultiGeneAngio. Read more about the study on the clinicaltrials.gov website.
Make an Appointment
To make an appointment to discuss your need for a PAD treatment plan designed for your specific needs, contact us toll-free at 888-287-1082 or email us at CVCCallCtr@med.umich.edu.