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St. Vincent's Medical Center, Bridgeport CT

Peripheral Artery and Vascular Disease (PAD)Advanced Procedures

Cardiology-Heart Services - St. Vincent's Medical Center, Bridgeport CT

The treatment for  both peripheral and carotid artery disease  includes:

  • Healthy lifestyle habits
  • Medications: anti-platelet medications such as aspirin to decrease the risk of blood clots and stroke; statins to reduce cholesterol levels; antihypertensives to lower blood pressure
  • Procedure to improve blood flow

Peripheral vascular disease (PAD) treatment

If adopting healthy lifestyle changes does not reduce your symptoms, angioplasty or bypass surgery may be considered to treat severe or limb-threatening peripheral artery disease.

A physician inserts a thin tube called a catheter through a blood vessel in the groin guiding it to the affected artery. Once the narrowed part of the artery is reached, the surgeon inflates a balloon to clear the blockage and restore blood flow.  A stent, which is a small, expandable wire-mesh tube, is placed in the artery to hold it open.

For the most part, angioplasty works best in larger arteries, and is most successful in the aorta and in the iliac arteries, which branch from the lower aorta. Angioplasty works better in the femoral arteries if the area of narrowing is short. Traditionally, bypass surgery has been preferred  when the narrowing has been  in the small popliteal and tibial arteries, but angioplasty in these arteries is becoming more effective with the latest advances in this procedure.

See also Non-Surgical Interventions.

Bypass surgery
The type of surgery is determined by location of the blockage. Common surgeries include: 

  • Aortobifemoral bypass, for narrowing of the aorta-the major abdominal artery-and the iliac arteries, which branch off from the aorta.
  • Femoropopliteal (fem-pop) bypass, for narrowing of the arteries in the thigh and knee. 
  • Femoral-tibial bypass, for narrowing of the arteries in the lower leg or foot.

The bypass surgeries can be done with a vein or with a man-made (prosthetic) graft. But vein grafts can keep the blood vessel open longer than the man-made grafts. See also coronary artery bypass surgery.

Deciding between angioplasty & bypass surgery
When making a decision about angioplasty versus bypass surgery, the physician considers the following: risks of the procedure, size of the arteries, and the number and length of the blockages or narrow passages.

Speak with your doctor / surgeon about the complexity of your blockages and your individual situation to determine which procedure is right for you.  

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