Peripheral Artery Disease (PAD)

Overview 

Peripheral artery disease, also known as peripheral vascular disease or more simply PAD or PVD, is a progressive circulation disorder in the legs and feet. PAD can occur when the blood vessels become narrower or blocked. 
When the legs do not receive adequate blood flow, you may experience leg pain when walking. Often PAD is a sign you may have more wide-spread atherosclerosis. Many people can treat PAD by quitting smoking, eating a healthy diet, and exercising. 

Peripheral artery disease causes 

Atherosclerosis, the buildup of plaque in the artery walls, is the most common cause of PAD. Plaque buildup limits the amount of blood that can flow efficiently to the limbs and decreases the oxygen that reaches the tissues. 

Other causes of PAD include:

• Blood clots form on the artery walls, potentially blocking off major arteries
• Infection
• Injury to the legs
• Irregular muscle or ligament anatomy in the legs
• Many people with coronary artery disease also have PAD

Peripheral artery disease risk factors

Factors that can increase your risk of developing peripheral artery disease include:

• Smoking
• High blood pressure
• Atherosclerosis
• Diabetes
• High cholesterol
• Older age
• Ethnicity (African Americans and Hispanics)

Peripheral artery disease symptoms 

The most common symptom of peripheral artery disease is pain in the legs with physical activity that gets better with rest. 

Other common symptoms of PAD include:

• Pain or aches in the buttock, hip, thigh, or calf
• Hair loss on the leg
• Skin on the leg that is cool to the touch
• Decreased pulses in the feet
• Sores on the legs that do not heal
• Numb or cold toes

Peripheral artery disease complications

Complications associated with PAD develop because of the decreased or absent blood flow. 

Complications include:

• Amputating a limb
• Poor wound healing
• Restricted mobility
• Severe pain in the affected limb
• Stroke. The risk of stroke is three times more likely in people who have PAD.

Following your doctor’s treatment plan can help prevent complications associated with PAD.

Peripheral artery disease diagnosis

If your doctor suspects you have PAD, he or she will perform an ankle-brachial index (ABI) to measure the blood pressure in your ankles compared to the blood pressure in your arms. The ABI will be performed while you are resting as well as after exercise.

Other imaging tests that help diagnose PAD include:

• Ultrasound
• Magnetic resonance angiography (MRA)
• Computed tomographic (CT) angiography

Peripheral artery disease treatment 

The goals of PAD treatment include controlling your symptoms, slowing or halting the progression of the disease, and lowering your risk of complications.

Your doctor will develop a customized treatment plan for your case.

Treatments may include:

• Lifestyle changes. Exercising, eating healthy, and quitting smoking can help slow the progression of PAD.
• Medications. Medications such as aspirin or antiplatelet medicines can prevent complications from PAD. Your doctor may also recommend taking cholesterol medicines to reduce your blood cholesterol.
• Vascular surgery to bypass blocked arteries.
• Angioplasty to open the arteries and restore blood flow. Types of angioplasty procedures include balloon angioplasty, atherectomy, laser angioplasty, or stent.

When to seek care

Schedule an appointment with your doctor if you have symptoms of PAD.

If you have already been diagnosed with PAD, schedule an appointment if your symptoms worsen or you develop new symptoms.