Peripheral artery disease (PAD) is a condition that restricts blood flow to the legs, causing pain and mobility issues. This circulatory problem occurs when plaque builds up in the arteries, narrowing or blocking them and reducing blood flow to the limbs, primarily affecting the legs. In the United States, PAD affects more than eight million people. Early treatment is crucial, as PAD can significantly impact quality of life and lead to severe complications if left untreated.
What is Peripheral Artery Disease?
PAD is a form of peripheral vascular disease (PVD) that develops when plaque builds up in the arteries of the legs, restricting circulation and increasing the risk of pain, slow-healing wounds, and mobility loss. As the disease progresses, limited blood flow prevents the leg tissues from receiving enough oxygen, making it difficult for the body to meet its demands during physical activity.
Who Is at Risk?
Risk factors for PAD include:
The risk of developing PAD increases significantly if you have multiple risk factors, particularly for those who smoke or have diabetes.
Symptoms and Diagnosis
Only one in four people experience typical peripheral artery disease symptoms, such as pain, aching, or heaviness in the legs. Many people do not have any symptoms, particularly early on in the disease.
PAD can cause pain or cramps, particularly with exercise. This type of pain is called claudication and can occur in the thigh, calf, or buttocks, making walking difficult. The pain caused by PAD may significantly limit your ability to engage in the physical activities you enjoy.
As the condition progresses, more significant signs that the condition is progressing may develop, including:
If you are at increased risk or have developed symptoms of PAD, your doctor will first start with a physical exam and ask you questions about your medical history.
Diagnosis is confirmed by ankle brachial index (ABI), which is an initial test followed by a lower extremity arterial ultrasound. In some cases, advanced imaging such as CT angiography or MRA may be necessary to visualize the full extent of arterial blockages.
Advanced Treatment Options for PAD
When conservative management (lifestyle modifications, exercise, and medication) has not adequately improved symptoms, your vascular specialist will determine the most appropriate next treatment approach based on your specific condition. The treatment plan varies depending on disease severity, location of blockages, and individual patient factors.
A minimally invasive angiogram is often performed both as a diagnostic tool and as part of the interventional procedure. This allows your vascular surgeon to visualize the blockages and address them during the same procedure when appropriate.
Other treatment options for PAD include:
- Angioplasty: Inserting a balloon into the artery to widen narrowed areas and improve blood flow.
- Stent placement: Inserting a mesh tube to keep the artery open after angioplasty.
- Atherectomy: Using a catheter with a small device to remove plaque from the artery.
- Shockwave angioplasty (IVL): Using sonic pressure waves to break up calcium deposits in the arteries.
- Bypass surgery: Creating a new path for blood flow around blocked arteries (for severe cases).
Summary of the Procedure & Recovery
An angiogram involves inserting a catheter into an artery, usually through the groin, and injecting contrast dye. X-ray imaging then visualizes blockages to guide further treatment decisions.
Under twilight anesthesia, a small puncture is made in the skin of the groin. The vascular surgeon can then use additional interventions during the same procedure, such as angioplasty or atherectomy.
Recovery from this procedure is quick, and the patient is on their feet within just a few hours. Patients who undergo successful angiograms often notice that the discomfort in their legs is resolved after the procedure.
Most patients can return to normal activities within days, making these procedures a great option for those seeking effective treatment with minimal disruption to their lives. Empire Vein and Vascular Specialists has performed over 4,870 PAD procedures with excellent results.
Why Choose Empire Vein and Vascular Specialists?
Our board-certified vascular surgeons have 30+ years of combined experience specializing in advanced, minimally invasive peripheral artery disease treatments. We are here to help you manage existing symptoms of PAD and reduce complications.
FAQs & Next Steps
My legs hurt. Do I have Peripheral Arterial Disease (PAD)?
Not necessarily! While PAD can cause leg pain, cramps, coldness, itching or burning in the extremities, or discoloration, there are many other causes of leg pain. Other causes may include arthritis, muscle cramps, a pinched nerve, and others. Talk to your doctor about your symptoms, and they will take a detailed medical history to help identify the potential causes. Your doctor can also order noninvasive testing such as an ankle brachial index (ABI) or an ultrasound to determine if you have PAD.
I have been diagnosed with PAD. Is there anything I can do to make it better?
While no medication currently exists to eliminate PAD, there are many things a patient can do to slow down the progress of PAD and improve their symptoms. First and foremost is to control any risk factors that can make the condition worse, such as quitting smoking, eating a healthy diet, and exercising. Controlling high blood pressure and cholesterol with lifestyle changes, and if needed, medications can also help improve the symptoms of PAD.
I have been diagnosed with PAD and have pain in my legs when walking. Why is my doctor telling me to walk even more?
Pain in the legs during physical activity due to PAD is caused by lactic acid buildup in the muscles caused by poor blood flow. This can lead to discomfort in the legs when walking short distances.
Research shows that patients who start an exercise regimen of brisk walking for 30 minutes or more a day will begin to develop collateral or detour arteries in the legs, which will help improve the blood flow. Over time, this will increase the distance that a patient can walk before they notice the discomfort.
Is there a “Drano” type of medication that can dissolve the plaque in my arteries?
Unfortunately, not. At present, multiple medications can treat many of the risk factors that cause PAD to help slow its progress. Your physician may also prescribe a blood thinner medication to aid in the treatment of PAD.
I have tried the conservative options, and my legs still hurt. What type of doctor should I see?
A board-certified vascular surgeon is a specialist in disorders of the circulation in the legs. All of our physicians at Empire Vein and Vascular Specialists are board-certified vascular surgeons who specialize in helping people improve their vein health and have performed over 4,800 procedures. When you visit us, we can discuss a variety of treatment options to improve your symptoms.
Do I need ongoing follow-up?
Follow-up is very important after intervention for PAD. The vascular team will schedule follow-up ultrasound visits for surveillance to check for any plaque that may develop in the future. Patients are also encouraged to maintain strict control of their risk factors to decrease the likelihood of recurrence.
Why should I choose Empire Vein and Vascular Specialists for evaluation of my PAD?
Our practice has over 30 years of collective experience in treating PAD. Empire Vein and Vascular Specialists have a state-of-the-art surgery center offering the latest technology.
Schedule a Consultation Today for expert PAD care.