How is peripheral arterial occlusive disease treated?
The therapy depends on the stage of peripheral arterial occlusive disease. In stages I and II, the aim is to improve the walking distance and thus reduce the patient’s discomfort. In contrast, in stage III and IV the aim is to preserve the affected extremity (usually the lower).
A distinction is made between a causal and a symptomatic therapy of peripheral arterial occlusive disease: stage-appropriate therapy of pAOD Basically, the existing risk factors should be eliminated as basic therapy. This includes giving up smoking, optimal diabetes mellitus treatment, treatment of high blood pressure (hypertension), and treatment of a lipid metabolism disorder (causal therapy). For this purpose, a healthy diet and regular exercise should be ensured.
In stage I and II of peripheral arterial occlusive disease, daily walking training (occupational therapy) should be performed. The aim is to strengthen the bypass circulation (collaterals) and thus to achieve a sufficient blood and oxygen supply to the tissue. To achieve this, patients should walk for about 1 – 1 1⁄2 hours daily at intervals.
This means stopping when pain occurs and continuing training when it subsides. Walking or pAVK groups are also available for this purpose. In the course of this training, the pain-free walking distance should increase. Occupational therapy should not take place if the blood supply is already very severely restricted in stage II, as well as in stages III and IV, as there is a risk of a critical oxygen deficiency with tissue damage due to the heavy load.
- The causal therapy is intended to eliminate the risk factors, thus removing the basis of the disease, i.e. preventing the progression of arteriosclerosis.
- Symptomatic therapy, on the other hand, aims to relieve the symptoms and eliminate the changes caused by arteriosclerosis.
- Ergotherapy (walking training): Stage I-II
- Drug therapy: Stage II-IV
- Revascularization (reopening of vessels): Stage II-IV
- Infection and wound treatment: stage IV
- Amputation: Stage IV
Since many patients also have changes in the coronary arteries (coronaries) as part of coronary heart disease (CHD), complications can be prevented.
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