How Is PAD Treated After a Surgical Procedure?

This article is for people who will be having a surgical procedure for peripheral artery disease (PAD), or anyone who wants to learn more about treatment for PAD. The goal of this patient education activity is to inform you about how PAD is treated after a procedure so that you can discuss your treatment plan with your doctor or healthcare provider.

You will learn:

• Why you may need a surgical procedure for PAD

• How PAD is treated after a surgical procedure

• Tips for staying healthy after your surgical procedure

• Questions to ask your doctor or healthcare provider

When you have PAD, your arms and legs (limbs) may not be getting enough blood and oxygen. This can happen if your blood vessels (arteries) have become blocked or too narrow from cholesterol build up, or if there is a blood clot.

You may be taking medicines to treat your PAD, but if your condition gets worse, your doctor or healthcare provider may recommend a surgical procedure to help improve blood and oxygen flow to the limb that needs it.

Two types of surgical procedures are done for PAD: endovascular and vascular surgery.

Endovascular procedures are done to open a narrowed or blocked artery, which can help to improve symptoms.

• Peripheral angioplasty: a small balloon is inflated inside a narrow artery to open it up

• Stent placement: during angioplasty, a thin mesh tube or "stent" is placed in the artery to permanently keep the artery open

Endovascular procedures are minimally invasive, and patients can usually go home the same day or the next day. They can go back to their normal daily activities within 1 week.

If you are not a candidate for angioplasty or stent placement you may need vascular bypass surgery.

Bypass surgery redirects or changes blood flow so that it goes around the blocked part of your artery. This is done by connecting a blood vessel or a synthetic tube from one part of your body to another.

Bypass surgery is performed under anesthesia. A vascular surgeon makes a cut in the leg where blood flow needs to be restored.

Bypass surgery is a major procedure done in patients who have severe PAD. It is more invasive than endovascular procedures, so patients usually go home within 5 days after the surgery. It may take about 4 to 6 weeks to recover.

After your procedure, you will still need to take medicines called blood thinners to continue treating your PAD. Blood thinners will help prevent blood clots from forming and treat them if they form after a surgical procedure.

There are 2 types of blood thinners: antiplatelet and anticoagulant medicines. These medicines work in different ways to stop or slow down a blood clot from forming in your artery.

• Antiplatelet medicines: aspirin or clopidogrel (Plavix®), aspirin taken with clopidogrel

• Anticoagulant medicine: rivaroxaban (Xarelto®) taken with aspirin

Depending on your overall health and which procedure you had, your doctor or healthcare provider might recommend taking 1 or 2 blood thinners for a few months. It is important to take blood thinners as prescribed and to go to your follow-up visits while you are taking these medicines.

Taking blood thinners can increase your risk of bleeding, which can be mild, moderate, or serious.

Call your doctor or healthcare provider if you have any of these serious side effects:

• Unusual bruising

• Bleeding for a long time from nosebleeds, cuts, the gums, shaving

• Blood in vomit, urine, or when coughing

• Unusual pain/swelling/discomfort

• Severe headache, dizziness/fainting, feeling tired

• Trouble swallowing

When you have PAD, it's important to practice good hygiene and to protect your arms and legs from developing injuries, sores, and infections. Having an open sore, wound, or an infection that does not heal can lead to tissue death and amputation of the limb.

Tips to practice good hygiene:

• Wash and moisturize your skin daily

• Be careful when cutting your finger and toe nails

• Wear comfortable shoes with socks

• Don't walk barefoot

• Check for infections (fungal or bacterial) and open sores or cuts daily

• Stretch and exercise regularly to get blood flowing

Some things can make your PAD worse, like having high cholesterol or diabetes, being overweight, and being a smoker. Along with taking your medicines as prescribed, practice these healthy habits to help prevent your PAD from getting worse:

• Quit smoking if you smoke

• Take your medicines for cholesterol and high blood pressure as prescribed

• If you have diabetes, lower and control your blood sugars

• Choose a healthy eating pattern (diet) with increased fruits, vegetables, and grains

• Be physically active for least 30 minutes, 3 to 4 times a week (when your doctor or healthcare provider says it’s okay to exercise)

• Drink plenty of water

• Limit drinking alcohol

• Manage stress

• Get 7 to 9 hours of sleep nightly

• Which blood thinner is right for me?

• How long should I take the blood thinner?

• What else should I do after my procedure to stay healthy?

• How long will it take for me to recover after the procedure?

• When should I get emergency help?

Congratulations!

You have successfully completed the program: "How is PAD Treated After a Procedure?"

View Additional Materials on this topic that you may find useful

American Heart Association: Peripheral Artery Disease Video

American Heart Association: Prevention and Treatment of PAD

American Heart Association: Track Your Symptoms

American Diabetes Association: Foot Complications