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Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD), also referred to as peripheral arterial disease or peripheral vascular disease, happens when blood vessels become narrow and reduce blood flow to the arms, legs, neck, or abdomen.

At UPMC, our vascular surgeons provide expert treatment for PAD and a range of other vascular diseases and conditions.

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What Is Peripheral Artery Disease (PAD)?

Peripheral artery disease (PAD) — also called peripheral arterial disease or peripheral vascular disease — happens when your blood vessels become narrowed and reduce blood flow to your limbs and organs.

Areas of the body that are commonly affected include the:

  • Arms.
  • Legs.
  • Neck.
  • Abdomen.

How common is PAD?

PAD is a common vascular problem, affecting about 8 million people in the United States.

What causes PAD?

PAD is usually caused by a gradual build-up of plaque within the arteries (atherosclerosis). Over time, plaque deposits harden and narrow the vessels, limiting the supply of oxygen to the legs and other parts of the body.

What are PAD risk factors and complications?

PAD risk factors

Risk factors for PAD include:

  • Blood vessel disorders.
  • Diabetes.
  • Family history of PAD.
  • High blood pressure.
  • High cholesterol.
  • Kidney disease.
  • Obesity.
  • Older age.
  • Smoking.

Complications of PAD

If left untreated, PAD can cause complications including:

  • Difficulty walking.
  • Increased risk for heart attack and stroke.
  • Organ and limb damage due to reduced blood flow.
  • Painful foot ulcers, infections, and even gangrene.

How can I prevent PAD?

You may not be able to control some of your PAD risk factors. However, preventing heart disease and chronic conditions can reduce the risk that you will develop PAD. You may be able to reduce your risk by:

  • Avoiding smoking.
  • Eating a diet that is rich in fruits, vegetables, and whole grains.
  • Exercising and maintaining a healthy weight.
  • Limiting alcoholic beverages.
  • Maintaining normal blood pressure and cholesterol levels.

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What Are the Signs and Symptoms of PAD?

PAD can develop over a lifetime with varying symptoms. The most severe forms of PAD can cause:

  • Amputation, when left untreated.
  • Blue or black discoloration of the toes.
  • Gangrene.
  • Infections.
  • Painful foot ulcers.

What are the warning signs of peripheral vascular disease?

Early PAD symptoms include:

  • Leg discomfort.
  • Leg pain or cramping that develops with walking and is relieved at rest (intermittent claudication).
  • Pain in the ball of the foot or toes while at rest.

When should I see a doctor about my PAD symptoms?

Getting early treatment for PAD may prevent your condition from getting worse and improve your quality of life. You should schedule an appointment with your doctor if you are having PAD symptoms.

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How Do You Diagnose PAD?

In most cases, your doctor can diagnose PAD through a physical exam. You may need other tests to measure its severity, especially if you have another condition such as diabetes.

What to expect during your visit

During your physical exam, your doctor will:

  • Ask about your symptoms and when they started.
  • Discuss your medical history.
  • Examine the affected area of your body.

If your doctor suspects you may have PAD, they may order additional tests.

Tests to diagnose PAD

To measure the severity of PAD, your doctor will order noninvasive tests such as:

  • A Doppler ultrasound scan — This test uses sound waves to create pictures of your arteries and find blockages.
  • An ankle-brachial index — This test measures blood pressure at the ankle and in the arm, the standard measure used to gauge the severity of PAD.

In some cases, to confirm a PAD diagnosis, you may need additional tests like:

  • CT scans — A CT scan is a test that creates images of organs and structures in your body.
  • MRI scans — MRI is a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within your body.
  • Cardiac catheterization (also called a coronary angiogram) — This test is a diagnostic procedure that allows your doctor to see blockages, blood flow, and other problems within your arteries.

PAD prognosis

Although there is no cure for PAD, getting early treatment can reduce symptoms, limit the risk of complications, and improve your quality of life.

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How Do You Treat PAD?

At UPMC, our vascular surgeons offer a full range of treatments for PAD. We will work with you to determine which treatment option is right for you based on the severity of your condition.

Lifestyle changes

Your doctor may recommend lifestyle changes to help reduce mild PAD symptoms, such as:

  • Maintaining a healthy weight.
  • Making changes to your diet.
  • Quitting smoking.
  • Regular exercise.
  • Walking.

Can drinking water help peripheral artery disease?

Staying hydrated has numerous health benefits. Studies have shown that proper hydration may reduce PAD symptoms. However, it’s important to talk to your doctor about how much water you should drink daily to ensure it is safe for you.

Medication

If you have mild PAD symptoms, your doctor may recommend medications to treat high blood pressure and cholesterol. Your doctor may also suggest medications to help you manage other chronic conditions, such as diabetes or kidney disease.

Minimally invasive treatment

If your PAD symptoms are moderate to severe, your doctor may recommend minimally invasive treatments, including:

  • Balloon angioplasty — During this procedure, your doctor will insert a small, thin tube called a catheter into your blood vessel through a small incision. Your doctor will guide the catheter to the site of the blockage. After the catheter is in place, your doctor will inflate a small balloon at the tip of the catheter to clear away the blockage.
  • Laser and atherectomy catheters — Atherectomy catheters have a rotating device at the tip that is used to remove blockages in your arteries. Laser catheters have an infrared laser at the tip that dissolves blockages.

Surgical treatment

For severe cases of PAD, your doctor may recommend surgical treatment, including:

  • Leg bypass surgery — During this procedure, your doctor will take a blood vessel from another part of your body and create a graft that reroutes blood flow around a blockage in your leg artery.
  • Amputation — If other treatment options have not successfully restored blood flow or if you develop a life-threatening infection, your doctor may recommend removing the affected limb through amputation.

How effective is treatment?

PAD treatment may reduce symptoms, improve quality of life, and prevent your condition from getting worse. Although there is no cure for PAD, early treatment can reduce the chances of complications.

What is the best treatment for peripheral artery disease?

The best PAD treatment for you will depend on the severity of your condition, your symptoms, your overall health and other factors. Your doctor will work with you to determine your best treatment option.

What is the life expectancy of a person with peripheral artery disease?

If left untreated, peripheral artery disease could cause serious complications that may reduce your life expectancy. You may also be at increased risk of developing coronary artery disease or other heart problems due to other untreated health conditions. It is important to work closely with your doctor to manage PAD and any other chronic health conditions.

Last reviewed by a UPMC medical professional on 2024-10-01.