How is Peripheral Arterial Disease treated?

This is a very good question. Essentially, there are three different treatments for patients with peripheral tear disease. One is a conservative treatment, so nothing needs to be done. As I said before, people with claudication, especially people who can walk 200 yards and then they feel the need to stop because of the cramps, these are the typical people where has been demonstrated that the treatment could be then we'll see endovascular open is not very helping because I mean the supervised exercise and the correct medical therapy with aspirin and of course astatin are giving the best results. So this is the conservative treatment. The intervention can come in two different forms, one is the endovascular one and one is the surgical one. Essentially, the endovascular is the new sort of guy on the block, so it was born in the 70s where some doctors understood that they could go through a little keyhole at the level of the common femoral artery, which is the artery at the level of the groin, to treat the arteries down, inframed arteries down into the leg, and through this keyhole they can pass a wire, they can pass some balloons which can open the arteries if needed and also they can put some stands which are a small cage of metals which keep the vessel patent for longer compared to angioplasty. These treatment needs to be tailored on the needs and the pathology on the severity of symptoms of the patients and of course again you know the multidisciplinary team is very important to assess these patients and to decide the best treatment for them. The other option is the surgical one which is very simple is that I mean at least to understand is the bypass so you take the artery where it's healthy and you connect the artery downstairs where it's healthy again through a tube. The tube could be made of two different materials and let's sort of one is the autologous vein for example you can use the great saphenous vein to create the bypass and actually this is the most durable and most demonstrated, you know, where the pedicel is demonstrated for longer, so essentially you connect point A to point B through this vein which with the time becomes like an artery, or if not there's the, you know, the second choice is to do it with a graft, but the graft has not the same property of the vein so it doesn't expand as well as the vein does so essentially every patient as I said depending on the amount of the disease depending of on the availability of veins because I mean after the great saphenous vein in the leg can be used other veins could be the vein in the arm but you know it's always second you know sort of second choice so every patient is to be assessed properly and the treatment needs to be tailored on what the patient really needs.