Peripheral arterial disease (PAD) occurs when the peripheral arteries become narrow. Atherosclerosis, a condition in which plaque made up of fat, cholesterol, and other substances sticks to the walls of the veins, is the most common cause. The plaque may reduce the flow of blood through the artery. It can also become brittle or inflamed. Sometimes, plaque causes a blood clot to form that can block the blood flow even more.

PAD can occur in the arteries leading to the arms, stomach, or head, but it occurs most frequently in the legs. The most common symptoms of PAD include cramping in the lower extremities, fatigue of the legs or hip muscles during motion, or pain in the legs or hips. The pain usually disappears with rest, only to return once you begin to move again.

It isn’t unusual for physicians to miss the diagnosis, often because the patient or their doctor mistakes the associated symptoms for other conditions. Under-diagnosis is a serious problem because of the increased risk of coronary artery disease, stroke, and heart disease that accompanies PAD. Patients who fail to get diagnosed and treated for peripheral artery disease may develop gangrene and, possibly, amputation.

Who Is at Risk for PAD?

People who smoke, have diabetes, high cholesterol, or high blood pressure are at a high risk for PAD. Your risk also increases as you get older. You should schedule an evaluation and learn your risk if you think you may have PAD.

Testing for PAD

Testing for PAD at the peripheral arterial disease clinic is easy and painless. The vein specialist will begin with a physical examination, which includes listening for bruits, or murmurs, that indicate poor wound healing.

-Ankle-brachial index (ABI) is a common test for PAD. The vein specialist will use this test to compare the blood pressure in the ankle with that in your arm.
-Ultrasound is another non-invasive testing method that allows the vascular doctor to identify the location of diseased arteries.
-Angiography is a minimally-invasive diagnostic test that involves the injection of a dye, or contrast material, that identifies narrowed arteries through X-ray, MRA, or CTA scans. Doctors sometimes use a more invasive method of catheter angiography in which they place a catheter through an artery in the groin to deliver the contrast material directly to the diseased area. The advantage of this diagnostic test is that the doctor can widen the narrowed vessel at the same time the test is performed.

The peripheral arterial disease clinic uses a variety of medications to treat PAD. High blood pressure medications, those used to treat diabetes, or cholesterol-lowering drugs can treat your specific conditions. Other methods of treatment include angioplasty in which a small balloon is inserted into the artery to stretch it open, and bypass surgery.

The right treatment for peripheral arterial disease starts with an accurate diagnosis. Don’t ignore the symptoms that may be the first signs of PAD.