Peripheral Arterial Disease Specialists

What is PAD?

Peripheral arterial disease (PAD) occurs due to a buildup of plaque (fat cholesterol and calcium) that accumulate in the walls of the artery. This condition can get severe enough to slow the flow of blood to the arteries in the legs and arms. This is usually caused by atherosclerosis, but the presence of atherosclerosis doesn’t always cause PAD symptoms.

One of the most signs common of PAD is claudication, which is described as cramping, tightening, or discomfort in the legs brought on by walking. The symptoms usually occur starting at the same distance, and generally disappear within a few minutes of rest. The most common location of claudication is in the calf, although it can also occur in the thigh and the buttock.

Other PAD symptoms include:

• Numbness and a burning sensation in the feet
• Coldness of the lower leg or foot
• Slower hair growth on the lower extremities
• Slower toenail growth
• Resting pain
• Lack of a pulse in the feet
• Open sores on the legs, toes or feet, which could develop into gangrene if slow to heal
• Blue toe syndrome
• Arterial ulcers
• Leg artery blockage
• Arterial ischemic ulcers
• Diabetic vascular disease
• Diabetic vascular blockage
• Total embolism

What causes PAD?

PAD is most often caused by atherosclerosis, otherwise known as hardening of the arteries.  If you have PAD in your legs, then your heart vessels may also be involved. Other causes of PAD include blood vessel inflammation, trauma to the artery, or the long-term effects of radiation.  

Many of the factors that increase your risk of developing PAD are controllable through lifestyle modifications. These risk factors include

• Smoking
• High blood pressure
• High cholesterol or triglycerides
• Obesity
• Diabetes
  

Uncontrollable risk factors include family history and increasing age, particularly after the age of 50.  

What are the risks if PAD is left untreated?

If PAD is left untreated and allowed to progress, there’s a good chance that you will develop difficulty walking, open arterial sores or ulcers on your legs, or severe pain in your feet at night, due to lack of circulation. There also is a concern of developing black gangrene, which will require some form of toe or leg amputation.

What does treatment entail?

Because advanced PAD can have serious consequences, treatment is focused on slowing down this progressive disease, while preventing any complications. This routinely includes lifestyle modifications such as:

• Smoking cessation
• Adaptation of a heart-healthy diet
• Cholesterol- and fat-lowering medication
  

If the PAD is significantly symptomatic, surgery may be required, including

• Angioplasty and stent placement
• Peripheral arterial bypass
• Vascular leg surgery
• Leg bypass surgery