What to know about living with Peripheral Artery Disease

Peripheral Artery Disease (PAD) is a chronic vascular condition that requires long-term management, even after successful treatment. If you’ve already been diagnosed and treated through angioplasty, stenting, or other interventions, it’s important to stay informed about lifestyle factors, medication adherence, imaging follow-up, and recurrence risks. Let’s explore some key questions that often arise after the initial phase of care.

Does smoking worsen PAD?

Smoking is one of the most harmful contributors to PAD progression. It damages the endothelium (the inner lining of blood vessels), promotes plaque buildup, and accelerates arterial narrowing. Nicotine, specifically, increases heart rate and blood pressure while reducing the amount of oxygen your muscles receive, further worsening PAD symptoms like leg pain during walking (claudication).

Continued smoking post-treatment significantly increases the risk of re-stenosis (re-narrowing of arteries), graft failure, and major adverse cardiovascular events (MACE), including heart attacks and strokes. Quitting smoking before and after your PAD procedure is essential. Within weeks of cessation, blood circulation improves and inflammation markers begin to drop, improving the overall effectiveness of your treatment.

Work with your care team on a structured smoking cessation plan, which may include nicotine replacement therapy, prescription medications, and behavioral counseling.

Do I still need medication after a PAD procedure?

Yes. PAD is a systemic disease, meaning treatment of one segment doesn’t eliminate the underlying atherosclerosis affecting the rest of your vascular system. Medications remain a critical part of your long-term management strategy.

Key medications include:

• Antiplatelets: These reduce the risk of blood clots forming at the site of the angioplasty or stent.
• Statins: Lower cholesterol and help stabilize plaque, reducing the risk of cardiovascular events.
• Antihypertensives: Blood pressure control is essential to slow disease progression and protect organ function.

Even if your symptoms improve dramatically after an intervention, stopping these medications prematurely can undo the benefits of your procedure.

Take all medications exactly as directed, even if your symptoms improve. Do not change the dose or stop any medication without consulting your doctor, as this may raise your risk of serious complications. Attend follow-up visits to adjust doses or manage side effects.

What’s the role of exercise in PAD recovery?

Supervised exercise therapy (SET), particularly structured walking programs, is one of the most effective non-invasive treatments for PAD. It helps your body form collateral circulation—small blood vessels that bypass blocked arteries—improving oxygen delivery to your muscles.

Exercise also strengthens your cardiovascular system, enhances metabolic health, and reduces inflammation. Studies show that patients who engage in regular walking therapy after angioplasty or stenting experience reduced leg pain, increased walking distance, and fewer PAD-related complications.

Aim for at least 30–45 minutes of walking three to five times a week. Supervised programs are more effective than unsupervised ones, especially in the early stages. If you’re unsure where to start, ask your vascular specialist for a referral to a certified program.

Can PAD come back after treatment?

Unfortunately, yes. PAD can recur. This may happen due to re-stenosis, where treated arteries narrow again over time, or because of progression in other parts of your vascular system.

Signs to watch for:

• Return or worsening of leg pain during walking
• Non-healing wounds or skin discoloration on the legs or feet
• Decreased pulse strength in the limbs
• Fatigue or cramping in the calf, thigh, or buttock during activity

Preventive strategies include:

• Strict control of risk factors
• Adherence to medications
• Routine follow-up imaging and clinical evaluation
• Ongoing physical activity and weight management

Stay alert to symptom changes and keep your scheduled check-ups. Early identification of re-stenosis allows for timely intervention.

Understanding PAD ultrasound and angiogram results

After diagnosis or treatment, your vascular specialist may use imaging to assess blood flow and monitor the success of an intervention. Here’s how to understand what these tests mean:

Ankle-Brachial Index (ABI): It compares the blood pressure in your ankle to your arm. A normal ABI is 1.0 to 1.4. An ABI below 0.9 suggests PAD; values below 0.5 indicate severe disease.

Doppler Ultrasound: The Doppler Ultrasound is a non-invasive test that uses sound waves to evaluate blood flow. It can identify blockages, reduced flow, or restenosis. Relevant terms include "triphasic flow" (normal), "biphasic" or "monophasic" (indicative of disease).

CT or MR Angiogram: It is used when more detailed imaging is needed, especially pre- or post-procedure. This test can highlight the exact location, length, and severity of blockages.

It’s important to ask your provider to walk you through your imaging results. Understanding your ABI trends or Doppler flow patterns will let you track progress and catch early signs of recurrence.

PAD treatment at RIVEA

PAD treatment requires ongoing commitment from both the physician and the patient. Whether it’s quitting smoking, maintaining medications, participating in exercise therapy, or monitoring for recurrence, these steps are crucial in ensuring lasting outcomes.

RIVEA offers comprehensive PAD care at every stage—from early symptom management to advanced interventions. As Hyderabad’s premier centre for vascular care, we help you take control of your condition with precision, compassion, and long-term support. Led by American board–certified vascular specialist Dr. Karthik Mikkineni, our team specializes in advanced, minimally invasive procedures designed to restore blood flow, relieve symptoms, and prevent limb loss.

Stay proactive in your care. Discuss any concerns or symptom changes with your vascular specialist early. With the right approach, it’s possible to live fully and independently even with PAD.