Peripheral artery disease (PAD) occurs when there is reduced blood flow in the extremities, mainly the legs. In the earlier stages, lifestyle changes and medications may help. As the problem progresses, there can be a serious risk of permanent damage or loss of your limbs. Surgical intervention may be necessary to restore the blood flow to your legs.
A blood clot or plaque can cause a blockage in a major blood vessel. Sometimes, surgeons will attempt to remove the obstruction, which helps restore blood flow. The procedure can be done with light sedation and local anesthetic. Your surgeon will use real-time imaging to guide a catheter to the blockage. The exact technique your surgeon will use to remove the blockage will depend on what is causing the obstruction. Some obstructions, such as blood clots, can be removed with a small spring or corkscrew-shaped device. This is threaded into the clot so it can be pulled free and removed. Harder obstructions may need to be chiseled away.
A stent may be used after a blockage is removed or it may be used after the narrowed area of a blood vessel is widened with a small balloon. Sometimes a blockage cannot be removed, but there may be enough room in the center for surgeons to press the material against the wall of the blood vessel and insert a stent, which can prevent the area from narrowing again. Without a stent, plaque may simply reform and create a new obstruction in the same area. Much like removing an obstruction, the procedure does not require general anesthesia and is done with minimal incisions.
Sometimes minimally invasive procedures are not an option, especially if there is a large obstruction or the obstruction is in an area that is difficult to reach. A bypass is used to reroute blood flow around the obstructed area. To perform a bypass, a healthy blood vessel is taken from elsewhere in your leg. This blood vessel is not essential and is providing collateral blood flow in the leg. Once the donor blood vessel is removed, both ends are transplanted to the recipient area, with one end sutured above and the other end sutured below the obstruction. Since the procedure requires general anesthesia, you will need to stay in the hospital longer, often for several days. Your surgeon will need to be sure the bypass is working and does not clot in the coming days before it is safe for you to leave.
When PAD reaches the point of causing limb-threatening obstructions, restoring blood flow is critical to keep the limb alive. There are different procedures available that can improve the blood flow in your lower limbs in many different situations. Learn more about vascular surgery from a local medical professional.