PAD is managed by reducing the “risk factors.” This includes quitting smoking, treating high blood pressure, diabetes and high cholesterol. Certain medications may help decrease the leg discomfort. Regular exercise is recommended. In patients who have ongoing symptoms despite these measures or severe disease that is threatening the loss of a leg, a percutaneous intervention (without incisions) is generally attempted before surgery since it is less invasive and has fewer cardiovascular risks. This may include angioplasty, stenting or atherectomy which is a minimally invasive method of removing the blockage. Some patients may require surgical bypass which often involves sewing in a graft to go around the blockage.