How is dry necrotic leg atherosclerosis treated?

Question
Hello doctor,
My father has atherosclerosis in his legs. Dry necrosis. The toes are sore. I asked the doctor to advise me on how to treat dry necrotic leg atherosclerosis? Thank you for the advice.
Hoan (1984)
Answer
Answered by Master. Doctor Phan Van Phong - Emergency Resuscitation Department, Vinmec Central Park International General Hospital.
Hello,
With the question “How to treat atherosclerosis of the legs with dry necrosis? , please answer as follows:
Your father has atherosclerosis of the leg arteries, is suffering from dry necrosis of peripheral artery disease. These arteries include the distal arterial systems such as the lower extremities, the upper extremities, the renal arteries, and the carotid arteries. Currently, treatment methods for peripheral artery disease include:
Quitting smoking, waterpipe: Support, counseling to quit smoking during each follow-up examination and treatment; develop an appropriate quitting plan; avoid exposure to environments where tobacco is used frequently (group contact with tobacco use, pipe tobacco). Improve diet, assist in regulating blood lipid levels and treat dyslipidemia. Coordinate rehabilitation exercises, exercise exercises under the supervision of medical staff about 3-4 times / week, each time lasting 30-45 minutes depending on the severity of the disease and the patient's ability and should last at least 12 weeks. It is recommended that this measure can improve symptoms and increase walking distance. Control comorbidities: Diabetes, hypertension, coronary artery disease if any. Advise diabetic patients fully on complications, especially tight control of foot complications. Support pain relief with analgesics or vasodilators suitable for each stage of the disease. Specific amputation may be considered in cases of severe necrosis, with the risk of total damage. Measures of reperfusion/revascularization: Revascularization is an appropriate indication recommended for patients with severe complications, manifestations of limb ischemia that do not improve nor are ability to control adverse factors and comorbidities. These include the following key measures: Catheter revascularization or percutaneous vascular intervention : A series of catheters are used, inserted through the skin into the blood vessels, using balloons and metal brackets (stent) placed in the lumen to re-establish blood flow. This method is recommended for use in most cases of peripheral artery disease today, especially in pre-amputation and prosthetic cases. Arterial bypass surgery: This method uses an autologous blood vessel from another location on the body or an artificial vessel that is grafted by the surgeon from above the lesion to below the lesion (bypass). ) to supply blood to the lower extremity through the surrogate vessel. However, you need to see a Vascular Specialist for appropriate treatment.
If you still have questions about the treatment of atherosclerosis of the dry necrotic leg arteries, you can go to the hospital of Vinmec Health System for examination. Thank you for trusting and sending questions to Vinmec. Wish you a lot of health.
Best regards!