What is Peripheral Artery Disease (PAD)?

Peripheral artery disease, also known as peripheral vascular disease (PVD), is a circulatory disorder affecting the legs or feet.

Peripheral artery disease is commonly caused by plaque build-up on the artery walls in the legs or arms.

Many people who have PAD do not experience symptoms. If you do have symptoms, the most common symptom is leg pain when you walk.

If left untreated, peripheral arterial disease can lead to severe complications such as limb amputation and stroke.

Causes of peripheral artery disease

Peripheral artery disease generally occurs when plaque builds up on the artery walls and limits blood flow. When this happens in the legs or arms, it is called peripheral arterial disease.

If the blockage is severe, it could lead to tissue death and potentially leg or foot amputation.

Other causes of peripheral arterial disease include:

  • Blood clots that form on the artery walls that break off and block other major arteries.
  • Infection.
  • Leg injury.
  • Radiation exposure.

Risk factors of peripheral artery disease

Smokers are the highest risk group for developing PAD because the chemicals in tobacco reduce blood flow.

Other factors can increase your risk of developing peripheral arterial disease, including:

  • High blood pressure.
  • High cholesterol.
  • Diabetes.
  • Plaque build-up in the arteries.
  • Family history of heart disease.
  • Obesity.
  • Older age.

Symptoms of peripheral arterial disease

The most common PAD symptom is leg pain that intensifies with physical activity and gets better with rest.

Other symptoms of PAD include:

  • Pain or discomfort in the hip, thigh, calf, or buttocks.
  • Numb or cold toes.
  • Slow healing leg wounds.
  • Decreased pulses in the feet.
  • Skin that is cool to the touch.
  • Hair loss on the affected leg.
  • Toenails that grow slowly.
  • Erectile dysfunction in men.

Some people do not experience any symptoms of PAD.

Complications of peripheral arterial disease

Complications associated with peripheral arterial disease are caused by reduced or absent blood flow. They can include:

  • Amputation.
  • Slow wound healing.
  • Infection in feet or legs.
  • Reduced or restricted mobility.
  • Pain in the affected limb.
  • Stroke.
  • Heart attack.

Early diagnosis and treatment can help prevent severe complications associated with PAD.

Diagnosing peripheral arterial disease

Your doctor can diagnose PAD. During a physical exam, your doctor will evaluate you for PAD signs such as weak pulse, poor wound healing, and decreased blood pressure in the affected limb.

If your doctor suspects you have PAD, he or she will likely perform an ankle-brachial index (ABI) test. An ABI test compares the blood pressure in your ankle to the blood pressure in your arm. An ABI test is a common noninvasive test used to diagnose PAD.

Other diagnostic tests used to diagnose PAD include:

  • Ultrasound. A Doppler ultrasound can help your doctor hear the blood flow through the blood vessels to identify blocked or narrowed arteries.
  • Angiography. Angiography allows your doctor to see how your blood is flowing through your arteries as it happens.
  • Blood tests. A blood test can measure your cholesterol and triglyceride levels.

Treatment for peripheral arterial disease

The goals of treatment for peripheral arterial disease are to:

  • Control your symptoms.
  • Slow the progression of the disease.
  • Lower your risk of complications.

Your doctor will develop a customized treatment plan for you based on your case’s severity.

Treatments may include:

  • Lifestyle and dietary changes. Quitting smoking, eating healthy, and exercising can slow the progression of PAD.
  • Vascular bypass surgery. Your doctor may take a vessel from another part of your body (or use a synthetic one) to bypass the blocked or narrowed vessel.
  • Angioplasty. Angioplasty can open up the arteries and restore blood flow in the legs.
  • Aspirin and antiplatelet medicines can prevent complications associated with PAD.
  • Cholesterol medicines can help reduce your blood cholesterol to reduce plaque build-up in the arteries.
  • Medications to control diabetes and maintain a healthy blood sugar level.
  • Blood pressure medications to help lower your blood pressure.

When to seek care

If you experience leg pain, numbness, or other common PAD symptoms, schedule an appointment with your doctor.

Schedule a PAD screening assessment in the following cases:

  • You are over 65 years old.
  • You are over 50 years old and are a smoker.
  • You are under 50 years old but have diabetes and other PAD risk factors.

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