However, a patient being considered for urokinase therapy needs careful screening to prevent hemorrhage. For elevated serum lipid levels, the physician may order antilipemic agents. Metabolic agents, such as carnitine, vitamin E, or prostaglandins, may minimize pain and promote ulcer healing. Estrogen replacement therapy may be appropriate for a postmenopausal woman. By exercising regularly, Mr. Torres can decrease his symptoms and increase his walking distance.
Exercise probably helps by enhancing collateral circulation and increasing tissue perfusion.
It also may allow him to develop a tolerance to muscle ischemia and so improve his comfort threshold. With a structured program, he may build up to 30 or 40 minutes of walking or exercise on a stair climber. Even daily walks in the neighborhood or a mall can help. Less risky than surgery, invasive techniques such as balloon angioplasty, atherectomy, and stenting may be used to restore blood flow or compress plaque. These techniques are relatively successful in treating the coronary and iliac arteries, where stenosis tends to be isolated.