Conditions & Procedures
Peripheral Artery Disease: Symptoms, Diagnosis, and Treatment Options
Peripheral artery disease (PAD) is one of the most common — and most under-diagnosed — forms of cardiovascular disease. It is estimated by the American Heart Association to affect millions of adults in the United States, often silently.
What is peripheral artery disease?
PAD is atherosclerosis — the buildup of cholesterol-rich plaque — in arteries outside the heart. It most often affects the arteries supplying the legs but can also involve the arms, kidneys, and other vascular beds. Risk factors include smoking, diabetes, high blood pressure, high cholesterol, age, and family history.
What are the symptoms of PAD?
- Leg cramping or fatigue while walking that improves with rest (claudication)
- Coldness, numbness, or weakness in one leg or foot
- Slow-healing sores on the feet or toes
- Changes in skin color or hair loss on the legs
- In advanced cases, rest pain in the foot or critical limb ischemia
Many patients have no symptoms, which is why screening is important in higher-risk groups.
How is PAD diagnosed?
The ankle-brachial index (ABI) is a simple, non-invasive test that compares the blood pressure in the ankle to the blood pressure in the arm. Additional studies may include arterial Doppler ultrasound, CT angiography, MR angiography, or invasive angiography when intervention is being considered.
How is PAD treated?
Treatment is individualized and typically combines several elements:
- Risk-factor management: smoking cessation, blood-pressure control, diabetes management, statin therapy
- Supervised exercise therapy
- Antiplatelet therapy as recommended by your physician
- Endovascular treatment such as balloon angioplasty, stenting, or atherectomy when symptoms are limiting or critical limb ischemia is present
- Surgical bypass in selected cases
What is the role of atherectomy in PAD?
Atherectomy is an endovascular procedure that removes or modifies plaque from inside the artery, often used in calcified disease where balloon angioplasty alone may be insufficient. We cover atherectomy in detail in a separate article.
What clinical research is underway for PAD?
Active research includes pivotal trials of advanced atherectomy systems for calcified lower-extremity disease, drug-coated devices, and novel pharmacologic strategies. Amavita Research participates in pivotal peripheral-vascular trials at our affiliated ambulatory surgery center in North Miami Beach, FL.
References
Frequently asked questions
What is peripheral artery disease (PAD)?
PAD is atherosclerotic narrowing of arteries outside the heart, most often affecting the legs. It can cause leg cramping with walking, non-healing wounds, and, in severe cases, critical limb ischemia.
What are early signs of PAD?
Common early signs include leg cramping or fatigue while walking that resolves with rest, coldness or numbness in one leg, and slow-healing sores on the feet.
How is PAD diagnosed?
The ankle-brachial index (ABI) is the most common first test. Additional imaging — Doppler ultrasound, CT or MR angiography, or invasive angiography — may follow.
Can PAD be treated without surgery?
Yes. Many patients are managed with risk-factor control, supervised exercise, and medical therapy. Endovascular procedures (angioplasty, stenting, atherectomy) are used when symptoms are limiting or limb is at risk.
Is PAD the same as coronary artery disease?
Both involve atherosclerosis, but they affect different vascular beds. People with PAD are at higher risk of coronary disease and stroke and should be evaluated globally.
Is PAD a focus of clinical research at Amavita?
Yes. Amavita Research enrolls patients in pivotal peripheral-vascular trials, including studies of advanced atherectomy systems for calcified disease.