Treating Peripheral Artery Disease and Deep Vein Thrombosis

Peripheral artery disease (PAD) and deep vein thrombosis (DVT) are vascular conditions that can greatly impact your overall health if left untreated. Fortunately, with medical advancements, there are effective treatment options available to help manage these conditions.^1,2

How is peripheral artery disease treated?

The goals of PAD treatment are to:^1,3,4

• Relieve symptoms
• Improve blood flow to affected limbs
• Reduce the risk of complications

Complications such as wounds that do not heal or severely blocked arteries (critical limb ischemia) can be very serious. So, it is vital to get treatment as soon as possible.^1,3,4

Treatment for PAD can include a combination of medicines, medical procedures, and, if needed, surgery.^1,3,4

Medicines

If you have PAD, your doctor may prescribe medicines to:^1,3,4

• Prevent blood clots – Medicines like aspirin or clopidogrel (Plavix®) are commonly prescribed to prevent blood clot formation and improve blood flow.
• Lower cholesterol – Statins help lower cholesterol levels, reducing the risk of plaque buildup in the arteries.
• Control blood pressure – If blood pressure is out of control, arteries can become stiff and hard.
• Control blood sugar – Blood sugar drugs may be used if a person with PAD also has diabetes.
• Help with leg pain – Some medicines help with leg pain in addition to thinning the blood and widening blood vessels. Examples of these kinds of drugs include cilostazol and pentoxifylline.

Medical procedures

In some cases, medical procedures to treat PAD are necessary. They can include:^1,3,4

• Angioplasty and stent placement – An angioplasty involves inflating a balloon to widen narrowed arteries. Then, a stent may be placed to keep the artery open. This procedure is minimally invasive and uses a thin catheter to widen the artery and place the stent.
• Atherectomy – This procedure involves removing plaque from the arteries using special devices.
• Thrombolytic therapy – If a clot is present, a “clot-busting” drug may be delivered directly into the affected artery. These drugs are given through a catheter, or IV line. This helps the drug go directly where the clot is located. The drug works immediately to dissolve the clot.
• Bypass surgery – In severe cases, bypass surgery may be needed. A bypass is done by creating a detour around a blocked artery, allowing blood to flow more freely.

Lifestyle changes

Healthy habits make a huge difference in treating and managing PAD symptoms. People with PAD should prioritize:^1,3,4

• Exercise – Regular physical activity can improve circulation and help manage PAD symptoms.
• Not smoking – Tobacco use wreaks havoc on blood vessels and worsens PAD symptoms.
• Healthy diet – A diet low in saturated fats and rich in fruits, vegetables, and whole grains is best for overall heart health.
• Avoiding cold and sinus meds – Pseudoephedrine, commonly used in over-the-counter cold medicines like Sudafed and others, can constrict blood vessels. If you have PAD or other vascular conditions, it is best to not use these OTC drugs.
• Taking care of their feet – PAD can increase the risk that cuts and wounds on the feet will not heal. Be sure to keep your feet clean and dry. Use special care when trimming your toenails. If you have a wound that is not healing, tell your doctor.

How is deep vein thrombosis treated?

The main goals of DVT treatment are to:^2,5

• Prevent the clot from growing larger
• Reduce the risk of pulmonary embolism (PE), a life-threatening condition in which a blood clot travels to the lungs
• Reduce the chance of another DVT occurring (recurrence)

Medicines

Several medicines are used to help treat DVT and the complications that can arise, such as PE. These drugs include:^2,5,6

• Blood thinners – Medicines that reduce the ability of the blood to clot (anticoagulants) are often prescribed to prevent blood clots and reduce the risk of complications. These medicines can be either injected into a vein or taken as a pill. Heparin is an example of an injectable blood thinner. Examples of oral blood thinner drugs include warfarin (Coumadin®), dabigatran (Pradaxa®), rivaroxaban Xarelto®), and apixaban (Eliquis®).
• Thrombolytics – When a blood clot is more serious or in cases of PE, these “clot-busting” drugs may be given to clear the clot. Examples include streptokinase (Streptase®), alteplase (Activase®), reteplase (Retavase®), and tenecteplase (TNKase®).

Medical procedures

If certain medicines cannot be used, or in more severe clotting cases, the following procedures may be necessary:^2,5

• Filter – When blood thinners cannot be used, a filter is another option. A filter is inserted in the inferior vena cava, a large vein that returns blood from the lower body to the heart. It acts as a barrier to trap clots from traveling to the lungs.
• Thrombectomy – In cases of large or severe clots, a surgical procedure called a thrombectomy may be necessary to remove the clot from the affected vein or lung (for PE).

Lifestyle changes

Here are some things you can do to help prevent complications from DVT:^2,5

• Wear compression stockings/socks – These stockings are extra tight and apply pressure to the legs. They promote blood flow and reduce the risk of complications. It can be a good idea to wear compression stockings if you know you will be sitting for a long period, like on a lengthy flight.
• Elevate your legs – Elevating the affected leg helps reduce swelling and promotes blood circulation.
• Get regular movement – Avoid long periods of sitting or not moving, especially during long flights or car rides. By moving around regularly, you reduce the risk of more blood clots forming.

Who treats peripheral artery disease and deep vein thrombosis?

Various healthcare professionals may be involved in PAD or DVT treatment and care. Your healthcare team may include:^7,8

• Vascular surgeons – Doctors who specialize in treating vascular conditions through surgical and minimally invasive procedures
• Vascular specialists – Doctors with expertise in managing vascular conditions, including PAD and DVT
• Cardiologists – Doctors who specialize in heart health
• Hematologists – Doctors who specialize in blood disorders who may help manage anticoagulant therapy

What is the prognosis of PAD?

For people with PAD, outcomes largely depend on the severity of the condition and how effective treatment is. You can stop PAD from getting worse by following your treatment plan, making healthy lifestyle changes, and addressing any other medical conditions (like diabetes or high blood pressure).³

However, advanced cases of PAD carry a higher risk of complications. These complications include wounds that do not heal and critical limb ischemia, which can lead to amputation in the most extreme cases.⁴

What is the prognosis of DVT?

The prognosis for people with DVT is generally good, especially when it is diagnosed and treated early. With effective treatment, many people can recover fully from DVT. But some may experience persistent symptoms or develop chronic leg pain and swelling (called post-thrombotic syndrome).^2,5

People with DVT need to stick to their prescribed medicines, attend regular follow-up appointments, and make lifestyle changes to reduce their risk of clots forming again.⁵

Can peripheral artery disease or deep vein thrombosis be prevented?

You may be able to prevent PAD and DVT, or at least significantly reduce your risk for these vascular diseases. Prevention happens through:^1-4

• Moving your body often and getting regular physical activity
• Eating a healthy diet
• Maintaining a healthy weight
• Not smoking
• Avoiding long periods of sitting or not moving
• Controlling blood pressure and blood sugar levels

If you have a family history of PAD, DVT, or other vascular diseases, tell your doctor. They can help you make a personalized prevention strategy with a focus on early detection.