Peripheral artery disease (PAD)

Peripheral artery disease, also known as peripheral vascular disease, is the hardening of the arteries outside the heart. Just as your heart arteries can become blocked or narrowed by plaque, so can the arteries in your legs, feet, arms, pelvis and other body areas. When plaque forms in these arteries, it’s difficult for blood to travel to your limbs and organs, particularly your legs.

Symptoms of peripheral artery disease

In the beginning, you may not have any symptoms. As PAD progresses, the most common symptom is an aching pain or cramping in your calf, thigh or buttocks when you walk or climb stairs. The pain usually goes away when you rest.

Other symptoms you may experience include:

• Changes in the skin, such as one leg feeling cooler than the other, or thin, brittle, shiny skin on your legs and feet
• Redness or bluish color in your legs, feet or arms
• Burning or aching pain in your feet and toes while resting or in bed
• Numbness, weakness or heaviness in the legs
• Hair loss on your legs or arms
• Poor toenail growth or a black or discolored toe
• Sores on the toes, feet or legs that won’t heal
• Gangrene in severe cases, which may require amputation

Causes & risk factors of peripheral artery disease

The buildup of plaque in your arteries, which is called atherosclerosis, causes peripheral artery disease.

You’re more likely to develop PAD if you have certain risk factors including:

• Age 60 or older
• High blood pressure
• High cholesterol
• Diabetes
• Smoking or other tobacco use
• Lack of physical activity or obesity
• Heart disease, family history of heart disease, or previous stroke or heart attack

Diagnosing peripheral artery disease

During your thorough physical exam, our specialists will look for signs of a narrowed or blocked artery. These include:

• A swooshing sound, called a bruit, in your artery
• A weak or absent pulse
• Lower blood pressure in one limb
• Wounds or sores on your limbs that aren’t healing

If we find any sign of peripheral artery disease, we may order additional tests for you, such as:

• Ankle-brachial index to compare the blood pressure in your ankle with the pressure in your arm to see how well your blood is flowing. We also may take readings before and immediately after you walk on a treadmill to see how exercise may have an effect.
• Angiography, such as magnetic resonance angiography (MRA) or computed tomography angiography (CTA), which is an imaging technique where we inject a contrast dye into your blood vessels to see how your blood flows through your arteries
• Ultrasound, an imaging technique that uses sound waves to create pictures of your body’s organs and blood vessels to detect any restricted blood flow

Find out more about our heart and vascular testing and diagnosis.

What is the best treatment for peripheral artery disease?

Your care is in the expert hands of some of the region's most experienced vascular specialists and surgeons. With you and your heart health our top priority, we’ll develop a care plan that’s right for you, using the latest in innovative minimally invasive and surgical techniques if needed.

We may recommend:

• Lifestyle changes such as eating a healthier diet, exercising more or quitting smoking and other self-care methods
• Medications to help lower your cholesterol, control your blood pressure or prevent blood clots
• Cardiac catheterization, a minimally invasive procedure where we guide a thin, flexible tube (catheter) through your blood vessel. If we find a blockage, we’ll inflate a tiny balloon to open your artery, which is called angioplasty. Or we’ll place a small cage, called a stent, to hold your artery open.
• Bypass surgery, a surgical procedure where our experts create a new path for your blood to flow around the blocked artery
• Endarterectomy, a procedure in which we surgically remove the plaque that’s built up inside your blocked artery
• Atherectomy, a minimally invasive procedure where we use fluoroscopy to directly target a complicated blockage and remove it. Sometimes this procedure can be an effective option to amputation. Learn more at our Limb Salvage Clinic.
• Wound care for wounds and sores that don't heal properly from our specially trained physicians and certified nurses at our Wound Care Center

What is peripheral artery disease self-care?

Prioritizing self-care habits is crucial if you have a PAD diagnosis. This involves activities such as walking, making healthy dietary choices and taking breaks when necessary. Whether these adjustments are significant or minor, focusing on your physical and mental well-being can enhance your overall condition.