Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD) is narrowing or blockage of arteries — most often in the legs — caused by atherosclerosis. It reduces blood flow to the limbs and signals widespread atherosclerosis throughout the body.

Table of Contents

Quick Facts

  • Type: Cardiovascular disease
  • ICD-10: I73.9
  • Hallmark symptom: Claudication
  • Risk: Heart attack, stroke

Overview

In PAD, fatty plaque builds up in the arteries supplying the legs, arms, stomach, or head. Most cases involve leg arteries. PAD shares risk factors with coronary artery disease and substantially raises the risk of heart attack and stroke.

Symptoms

  • Intermittent claudication — leg pain or cramping with walking that goes away with rest
  • Coldness or color changes in the lower leg or foot
  • Weak or absent pulse in the leg or foot
  • Slow-healing sores on the toes, feet, or legs
  • Hair loss or slower hair growth on the legs
  • Shiny skin and brittle toenails
  • Erectile dysfunction (in men with iliac artery disease)

Severe PAD can cause pain at rest, especially at night when legs are elevated, and can lead to tissue loss (critical limb ischemia).

Risk Factors

  • Smoking (the strongest modifiable risk factor)
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Age over 60
  • Family history of vascular disease

Diagnosis

  • Ankle-brachial index (ABI) — compares blood pressure in the ankle to the arm
  • Pulse exam and listening for bruits
  • Duplex ultrasound
  • CT or MR angiography
  • Invasive angiography in selected cases

Treatment

Lifestyle and medical

  • Smoking cessation — the single most impactful intervention
  • Supervised exercise program (often pain-relieving and improves walking distance)
  • Statins
  • Antiplatelet therapy (aspirin or clopidogrel)
  • Blood pressure and diabetes control
  • Cilostazol or pentoxifylline for symptom relief in some patients

Procedures

  • Angioplasty and stenting
  • Atherectomy
  • Surgical bypass for severe disease

When to See a Doctor

See a doctor for leg pain with walking, slow-healing wounds, or color changes. Seek emergency care for sudden, severe leg pain with pallor and pulselessness — this may be acute limb ischemia and is time-critical.

Related Conditions

Coronary Artery Disease

Same disease process in heart arteries

 Heart Disease

Often coexists with PAD

 Diabetes

Major PAD risk factor

 Leg Pain

Common PAD presentation

Frequently Asked Questions

Is PAD the same as DVT?

No. PAD is narrowing of arteries (carrying oxygenated blood outward). Deep vein thrombosis (DVT) is a clot in a vein (carrying blood back to the heart). They have different causes and treatments.

Can PAD lead to amputation?

Severe untreated PAD can lead to non-healing wounds and gangrene, occasionally requiring amputation. Early diagnosis and aggressive risk-factor control dramatically reduce this risk.

Should I walk if walking causes leg pain?

Yes — supervised exercise that brings on claudication and then resting is one of the most effective treatments for PAD, gradually increasing pain-free walking distance.

Why does my doctor want to check my cholesterol if I have PAD?

PAD is a sign of body-wide atherosclerosis. Lipid lowering reduces the risk of heart attack and stroke, which are the most common causes of death in PAD.

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Heart Association. PAD Patient Resources.
  • ACC/AHA Guideline. Management of Patients with Lower Extremity PAD.