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PAD Treatment Options: Which Is Right for Me?

Do you experience regular leg pain or numbness? Does leg discomfort wake you up in the middle of the night? Is one of your legs or feet constantly colder than the other? If so, then you may be one of the nine million Americans who are affected by peripheral artery disease (PAD) each year.

While PAD is a serious circulatory issue, several minimally invasive and conservative treatments exist to manage symptoms and prevent the disease from worsening. At IVC, we offer a wide range of PAD treatments to provide options to patients with varying needs. If you suffer from PAD or have begun to experience symptoms, seek treatment immediately to both improve your quality of life and ensure you are not at risk of more life-threatening conditions.

Diagnosing PAD

PAD develops when the buildup of arterial plaque impedes blood flow to the extremities. PAD is typically the result of atherosclerosis, the accumulation of cholesterol and fatty deposits in the arteries due to a range of factors. People at risk of developing PAD are those who smoke, are diabetic, are obese, have a family history of PAD, live a sedentary lifestyle and men and women over the age of 50. Any condition or activity that lowers blood pressure can create a higher chance of developing PAD.

The arteries are responsible for providing oxygen-rich blood to the organs and extremities. PAD can prevent the legs, arms, hands and feet from receiving the blood flow necessary to operate properly. As a medical condition, PAD specifically refers to an arterial blockage that affects the outer extremities of the body, but it can be indicative of a larger blood flow issue that affects the heart, brain and other vital organs.

PAD typically only affects the legs, although it may be evident elsewhere for some patients. Some common symptoms of PAD include:

  • Pain when sitting or lying down, especially in the calves
  • Open sores on the legs that do not heal
  • Difficulty sleeping due to leg discomfort
  • Constant coldness in one leg or foot
  • Skin discoloration in the lower body
  • Slower leg hair or toenail growth
  • Erectile dysfunction

If symptoms are left untreated, PAD can progress and cause severe health issues. Open sores or injuries on the lower body may not heal due to a lack of blood flow and can eventually lead to tissue death which may require amputation of the affected limb. PAD is also a sign that blood flow may be poor elsewhere in the body. Arterial blockage located near the brain or heart can cause stroke or death, so take any of the above symptoms very seriously and seek treatment at their onset.

Conservative Therapy

Conservative therapy involves the use of nonsurgical and noninvasive treatment options to manage various diseases, health issues and injuries. As a form of treatment for PAD, conservative therapy typically consists of making lifestyle changes that increase blood flow and overall health. Smoking automatically lowers your blood pressure, so quitting smoking or switching to tobacco-free, smokeless nicotine products can make an immediate improvement.

Exercising regularly also increases blood flow and can provide blood to the outer extremities, as well as improve overall health and lower cholesterol. A healthy diet low in fat and high in vegetables and lean proteins will also lower cholesterol and counteract obesity.

If your family has a history of PAD or vein and artery issues, then utilizing preventative measures is very important to ensure PAD does not develop as you age. Maintaining a healthy lifestyle and scheduling regular appointments with your doctor, as well as responding immediately to the development of any PAD symptoms, is crucial to preventing the disease. If conservative therapy has proved unsuccessful or your PAD has progressed too far, then minimally invasive treatment options may be right for you.

Angioplasty and Stenting

Angioplasty is a nonsurgical procedure that increases blood flow in the blocked arteries using a balloon catheter. Angioplasty is also commonly combined with the use of stents, small wire mesh tubes that are placed in the arteries to hold them open. During an angioplasty procedure, a balloon catheter is directed to the blockage under image guidance. The balloon is then inflated, compressing the plaque against the artery’s walls and opening up blood flow. Stents may be left in place to keep the artery propped open and prevent it from narrowing again.

Angioplasty is minimally invasive and does not require general anesthesia or incisions. The catheter is inserted through a small nick in the skin and local anesthesia is typically used, allowing most patients to return home the same day. Normal activities can be resumed after one to two days of rest, so you can expect to be back on your feet quickly with minimal side effects following angioplasty.

Thrombolysis and Thrombectomy

Thrombolysis and thrombectomy are two minimally invasive procedures that eliminate arterial buildup using similar methods. During thrombolysis, a catheter is directed to the blockage using image guidance. Medicine that dissolves the blood clot is then injected through the catheter to clear the artery and increase blood flow. Thrombectomy utilizes a similar procedure, but the clot is either directly removed or broken up using a special medical instrument rather than a dissolving medication.

Like angioplasty, you can expect to resume normal activities quickly following either procedure. Most patients are back to their normal routines the next day, although you will need to avoid strenuous activities for 24 hours. No incisions are required for either procedure, and side effects are almost nonexistent after the first few days of recovery.


Atherectomy is an additional minimally invasive procedure that increases arterial blood flow caused by plaque buildup. During atherectomy, a catheter equipped with a sharp blade at the tip is image-guided to the blockage. The blade is then used to break down and remove the plaque, storing it in a small chamber in the catheter where it is then removed from the body.

Like other PAD procedures, atherectomy only requires a day or two of downtime before resuming normal activities. Atherectomy can be repeated as necessary if arterial plaque buildup continues and is frequently combined with other PAD treatment options depending on the patient’s needs.

Which Treatment Is Right for Me?

While PAD is a serious health issue and can lead to severe complications, many minimally invasive procedures and conservative treatments can provide you with relief from symptoms and prevent the condition from worsening. Each minimally invasive procedure has different uses and may not be an option for every patient.

At IVC, we will work with you on an individual basis to determine which treatment option is best to manage your PAD. With the help of one of our vascular and interventional radiologists, you may be able to experience relief and eliminate health issues without resorting to painful and overly invasive surgical treatments.

Managing PAD at IVC

If you suffer from PAD or have begun to experience symptoms in line with arterial blockage, then schedule a consultation at IVC to diagnosis your condition and formulate a treatment plan. Call us today at 503-612-0498 to schedule your appointment.

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We are announcing that Interventional and Vascular Consultants will be closing as of March 10, 2023.

We would like to thank you for the trust you have given us over the years, participating in your healthcare needs has been a privilege.

To assist in a smooth transition to a new provider, you may access your records from your MyHealth account or request a copy of medical records by clicking the link below and completing the Release of Information form.

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Please know that we have greatly valued our relationship with you and wish you the best.


Jason Bauer, MD RVT
Michael Pfister, MD RVT

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