As often as possible, doctors attempt to help patients resolve or manage health conditions with lifestyle changes. Sometimes, this is not enough to preserve long-term health. Here, we discuss when surgery may be recommended for the treatment of peripheral artery disease (PAD).
Peripheral Artery Disease: A Sticky Mix
Peripheral artery disease occurs when plaque, a sticky mix of calcium, fat, cholesterol, and other substances builds up in the arteries. This buildup most often occurs in the legs, although it can also develop in the arteries that circulate blood through the head, arms, stomach, or kidneys. Peripheral artery disease that occurs in the legs can lead to pain during physical exertion. More concerning, it contributes to a higher risk of stroke and heart attack.
When peripheral artery disease is mild to moderate, a doctor may recommend medication and lifestyle changes to protect health. In more severe cases or if conservative approaches do not achieve expected results, surgery may be recommended. Two of the three common procedures performed for PAD are minimally invasive treatments, not full, open surgery. These include angioplasty and atherectomy.
- Angioplasty is the procedure that is performed to widen the affected artery so blood circulates more freely. This procedure is performed with a sedative and local anesthesia, not general anesthesia. Though awake, patients are calm and comfortable. Angioplasty may involve inserting a small tube into the artery and inflating a tiny balloon at the end of the tube. The inflated balloon compresses arterial plaque. During this procedure, the doctor may also place a stent, a small mesh device, to hold the artery open.
- Atherectomy removes plaque from the artery. Also performed under a local anesthetic and sedative, this technique inserts a small tube into the artery. This catheter has a tiny instrument on its tip that removes plaque from the artery walls. After this step, a balloon may be inserted and inflated to open the artery even more. A stent may also be placed to maintain the artery.
If there is a large blockage or the artery has narrowed after minimally invasive procedures have been done, bypass surgery may be necessary. Bypass surgery reroutes blood flow to move around the blockage. To achieve this, the surgery may use a small tube or a vein from another part of the body. The new passageway is connected to the artery before the blockage and then again on the other side of the blockage.