Prevention and Treatment of PAD

Treatment for peripheral artery disease, or PAD, focuses on reducing symptoms and preventing further progression of the condition. In most cases, lifestyle changes, exercise and claudication medications are enough to slow the progression or even reverse the symptoms of PAD.

View our interactive library to learn more about PAD. 

Smoking cessation

Tobacco smoke is a major risk factor for PAD and increases your risk for heart attack and stroke. If you smoke, take steps to quit. Effective tools include behavior modification programs, nicotine replacement medicines and other quit-smoking medications. Quitting smoking will help slow the progression of PAD and other heart-related diseases. Ask your health care professional for guidance to help you quit.

Learn how you can kick the habit.

Physical activity

An effective treatment for PAD symptoms is regular physical activity. Your health care professional may recommend supervised exercise training, also known as supervised exercise therapy, or SET. You may have to begin slowly, but simple walking regimens, leg exercises and treadmill exercise programs can ease symptoms. 

Exercise for leg pain (intermittent claudication) considers that walking causes pain. The program consists of alternating activity and rest in intervals to build up the amount of time you can walk before the pain sets in. It’s best if this exercise program is done in a rehabilitation center on a treadmill and monitored. If it isn’t possible to go to a rehab center, your health care professional may recommend a structured community or home-based program.

Learn more about cardiac rehabilitation.

Diet

Many people with PAD have elevated cholesterol levels. A diet low in saturated and trans fat can help lower blood cholesterol levels. Cholesterol-lowering medication may also be needed.

Aim for a healthy diet that emphasizes vegetables, fruits and whole grains. Include low-fat dairy products, poultry, fish, legumes, nuts, seeds and non-tropical vegetable oils such as olive oil. Choose foods that are unprocessed or minimally processed. Limit sodium, saturated and trans fats, added sugars, sugar-sweetened beverages and red meat.  

Medication

It’s important to take the medication that your health care professional prescribes. Not taking these medications can increase your risk for PAD, as well as heart attack and stroke. Medications that may be prescribed include:

• Antiplatelet medication, such as aspirin and/or clopidogrel, to prevent blood clots
• Cholesterol-lowering medications, such as statins
• High blood pressure medications (In people with PAD and high blood pressure, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers are recommended.)
• Oral anti-coagulants, such as rivaroxaban, to decrease the tendency for blood clots to form

If you have claudication, you also may be prescribed medication (cilostazol) to help improve your walking distance and decrease leg symptoms. 

Talk to your health care professional about what medications you may need based on your condition and other risk factors.

In addition, people with PAD should receive an annual flu vaccine and the COVID vaccine plus boosters.

Managing diabetes

Diabetes increases the risk of poor outcomes among people with PAD. Achieving glucose control benefits all people with diabetes and can reduce limb-related complications in those with PAD. 

Work with your health care team to create a coordinated care plan, including:

• A healthy diet to reduce your cholesterol and manage diabetes
• Reaching and maintaining a healthy weight
• Medications for glucose management
• Managing other cardiovascular risk factors
• Foot care and ulcer prevention

Procedures

For some people with PAD, the above recommendations and treatments aren’t enough. So, minimally invasive treatment or surgery may be needed.

• Angioplasty or stent placement (as done in the heart for coronary artery disease) are procedures performed by making a small incision through which a catheter is inserted to reach the blocked artery. A tiny balloon is inflated inside the artery to open the clog. A tiny wire mesh cylinder called a stent may also be inserted at this time to help hold the artery open. Sometimes a medicine can be administered through the catheter or a special device can be inserted through it to remove a clot that’s blocking the artery. 
• An atherectomy is a minimally invasive procedure to remove plaque from the artery. Similar to angioplasty, a catheter is inserted into the blocked artery. The catheter has a sharp blade, or cutter, on the end to cut, collect and remove the plaque from the blood vessel.
• Bypass surgery may be needed if a long portion of artery in your leg is completely blocked and you’re having severe symptoms. A vein from another part of the body is used to “bypass” and reroute blood flow around the closed artery. 

Your health care professional will discuss your treatment options and help choose the best one for you. Get the most out of your next appointment with the PAD Discussion Guide.