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When is invasive treatment used for peripheral artery disease?

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Patients with peripheral artery disease who can tolerate surgery may benefit from invasive procedures when conservative treatment measures are unsuccessful and the disease is severe, explains Merck Manuals. Indications include intermittent claudication that inhibits daily activities, pain during rest, and gangrene.

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Invasive treatment options include percutaneous transluminal intervention, thromboendarterectomy, revascularization and amputation as a last resort, according to Merck Manuals. Before these procedures are considered, patients often try noninvasive treatment options, which include risk factor modification, exercise and medications.

Exercise is an underused method of symptom relief in patients with peripheral artery disease, and 35 to 50 minutes of walking can provide substantial relief of symptoms, explains Merck Manuals. The benefits of exercise include an increase in collateral circulation, microvascular dilation, decrease in blood viscosity, improved red blood cell filtration and improved oxygen extraction.

Anti-platelet drugs improve circulation and increase walking distance tolerance, states Merck Manuals. They include aspirin, aspirin plus dipyridamole, clopidogrel and ticlopidine. Claudication can be relieved with pentoxifylline and cilostazol, ACE inhibitors, L-arginine, nitric oxide, vasodilator prostaglandins, and angiogenic growth factors.

The symptoms of peripheral artery disease include painful cramping in the hip, thigh and calf muscles after physical activity as well as leg numbness, weakness and coldness, describes Mayo Clinic. Patients may also notice a shiny skin appearance, a change in the color of the legs, slow hair growth on the legs, and slow toenail growth. Other symptoms include erectile dysfunction and weak pulses in the legs and feet.

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