Peripheral Artery Disease Treatment

If you have symptoms of peripheral artery disease (PAD), expert care is important to protect your health over the long term. At Penn Medicine Lancaster General Health, our vascular team has extensive training and experience in treatment to manage PAD and prevent complications. We’re dedicated to helping you achieve your best health.

What Is Peripheral Artery Disease (PAD)?

PAD is narrowing or blockages in arteries that carry blood and oxygen to your arms and legs. Also called peripheral vascular disease, PAD develops more commonly in the legs.

Atherosclerosis, a buildup of cholesterol and other fatty substances inside artery walls, is the main cause of PAD. As the buildup (plaque) worsens, it causes arteries to narrow and stiffen.

Without prompt, effective treatment, blood flow can become severely restricted. This reduced blood supply, called critical limb ischemia (CLI), can lead to tissue death, which may require amputation of the affected limb.

Peripheral Artery Disease (PAD) Treatment: Why Choose Penn Medicine Lancaster General Health?

Our vascular specialists provide the full spectrum of PAD treatments, from medications and wound care to minimally invasive procedures and surgery. Getting the right care early can help prevent complications that can worsen your health and lead to amputation.

You can expect:

• Board-certified vascular specialists: Your care team includes vascular surgeons and vascular medicine specialists who have training and experience in diagnosing and managing PAD. We have extensive knowledge of the latest minimally invasive procedures and traditional, open surgical techniques. That expertise offers you more treatment options and longer-lasting results.
• Team approach: Our interventional vascular unit (IVU) brings together vascular surgeons, vascular medicine doctors and interventional radiologists to treat PAD and other vascular conditions. The team specializes in minimally invasive procedures, which use catheters and small incisions to treat vascular diseases.
• Newest diagnostic imaging techniques: As part of our evaluation, we offer the latest ultrasound and other imaging technologies in our vascular lab. Accredited by the Intersocietal Accreditation Commission, our lab meets the highest standards of patient care, with registered vascular technologists certified in vascular imaging technology.
• Ongoing health management: You receive seamless, coordinated care from diagnosis through treatment, including vascular rehab. Your care team sees you regularly for ongoing management so you can enjoy a full, active life.
• Focus on improving our care: We’re the only hospital in Lancaster County and one of few in the region that reports our patient outcomes to national registries. We continually measure our results against national outcomes so that we can find ways to improve patient care for you.

Specialized Treatments for Peripheral Artery Disease (PAD)

Your care team works closely with you to tailor a treatment plan for you, based on your test results and our confirmed diagnosis. When possible, we begin with the least invasive treatment method.

Our full spectrum of treatment options includes:

Counseling About Healthy Lifestyle Habits

If you smoke, quitting is the most important change you can make to help manage atherosclerosis and PAD. Our doctors will recommend resources to help smokers quit.

Diabetes and high blood pressure can increase your risk of developing PAD. Exercise and a healthy eating plan can help prevent these conditions and relieve their symptoms. LG Health offers nutrition consulting for people who have diabetes through our Diabetes and Nutrition Center. Find resources to help you improve your physical activity and nutrition, and learn more about quitting smoking.

Wound Care and Self-Care for Feet

You may have a higher risk of developing chronic, non-healing wounds on your feet and legs, especially if you also have diabetes. Chronic wounds can become infected and lead to tissue death, which may require limb amputation if severe.

Your care team can show you how to take care of your feet at home. You can also find specialized wound care at LG Health.

Medication

Medication helps relieve your symptoms and manage other health conditions that contribute to PAD. Depending on your specific needs, we may prescribe:

• Statins to control high cholesterol
• Medications to lower blood pressure
• Insulin or medications to manage blood sugar
• Blood thinners to improve blood flow and prevent clots
• Vasodilators to widen narrowed arteries to improve blood flow

Minimally Invasive Procedures

Our board-certified vascular surgeons have extensive training and experience in the latest minimally invasive (endovascular) procedures to treat PAD. It’s important to choose a surgeon with intimate knowledge of these procedures and traditional, open vascular surgical procedures. We help you decide which type offers the best possible results for you.

Endovascular treatment involves only a small incision, and most people can go home the same day. A minimally invasive procedure can heal faster with less pain, so you have an easier recovery.

The endovascular procedures we offer for PAD include:

• Angioplasty: We usually perform angioplasty during the same procedure as a diagnostic angiogram. In an angiogram, your doctor inserts a catheter (long, thin tube) into an artery, usually in the groin but sometimes in the foot. The doctor carefully guides the catheter through arteries to the treatment site to take pictures. Next, your doctor guides a catheter tipped with a tiny balloon to the treatment site. The doctor inflates the balloon to widen the artery. This widening compresses any blockages (plaque) against the artery walls to improve blood flow.
• Stenting: During an angioplasty, we may insert a stent (tiny mesh tube) into the affected artery to help keep it open. Some stents are coated with medication that slowly releases to prevent future blockages.
• Atherectomy: In some cases, we may decide to remove plaque rather than compress it. During an angiogram, the doctor uses a catheter tipped with a tiny blade to cut away plaque. The doctor removes any large pieces of plaque. Small pieces of plaque can wash away in the bloodstream.

Peripheral Artery Disease Surgery

Some people with advanced PAD may have more severe blockages in an artery. A blockage may also redevelop in an area that had previous angioplasty or stenting. Our vascular surgeons perform open surgery to remove blockages or bypass blocked areas in arteries.

The vascular surgical procedures we offer for PAD treatment include:

• Peripheral endarterectomy: The surgeon accesses the blockage through an incision near the artery, then opens the blocked section of the artery. The surgeon removes the plaque and, in some cases, the diseased part of the artery. In those cases, the surgeon closes the artery with a patch made of synthetic material or a portion of another blood vessel.
• Peripheral artery bypass: The surgeon makes an incision near the blocked area of the artery and attaches a graft above and below the blockage to reroute blood flow around it. The graft can be a synthetic tube or a portion of a blood vessel from elsewhere in your body.