Peripheral artery disease, or PAD, is a common condition that affects millions of people. It happens when the arteries in your legs become narrow or blocked, usually because of a buildup of plaque — a mix of fat, cholesterol and other substances. Plaque buildup reduces blood flow to your legs and feet, which can cause pain, cramping and other serious problems.
Fortunately, there are several options for treating PAD that can help improve circulation and relieve symptoms.
What causes PAD?
PAD is most often caused by atherosclerosis, a condition in which plaque builds up inside the arteries. This buildup makes it harder for blood to flow. Over time, this can lead to pain when walking, slow-healing wounds, and even tissue damage. Risk factors for peripheral artery disease include:
- Age: PAD can occur at any age. However, the risk for PAD increases as you age, especially those that are 65 and older and with at least one other risk factor for atherosclerosis. We also sometimes see severe PAD in the younger population, especially in our community, mainly in those who smoke or use any form of tobacco.
- Smoking: Because smoking damages your blood vessels, smokers are three times more likely to develop peripheral artery disease than nonsmokers.
- Diabetes: Prolonged, uncontrolled diabetes can damage blood vessels and increase the risk of blockages.
- High blood pressure: Puts extra strain on artery walls, making them prone to damage and narrowing.
- High cholesterol: Contributes to plaque buildup, restricting blood flow.
- Being overweight: Extra weight forces your heart and blood vessels to work harder, raising the risk of damage and PAD.
- Not getting enough exercise: Being inactive can worsen circulation and contribute to other risk factors, such as obesity and diabetes.
- Family history of heart or blood vessel disease: PAD can run in families, so having close relatives with heart or blood vessel problems may increase your chances of developing it.
How is PAD diagnosed?
If you have leg pain when walking or notice coldness or numbness in your feet, your doctor may check for peripheral artery disease. Diagnosis usually starts with a physical exam and questions about your symptoms. Your doctor may check the pulse in your legs and feet to detect poor leg circulation.
Common tests include:
- Ankle-Brachial Index (ABI): Compares blood pressure in your ankle and arm. A low ankle brachial index reading can mean there is a narrowing or blockage of the arteries in the legs.
- Ultrasound: Uses sound waves to see how blood flows through your arteries.
- Angiography: Uses dye and imaging to look for blockages.
- Blood tests: Check for high cholesterol, diabetes and other risk factors.
What are the treatment options for peripheral artery disease?
The best treatment for PAD depends on how severe it is and your overall health. Here are the main options:
Lifestyle changes
Lifestyle changes are often the first step in treating PAD and can make a huge difference:
- Quit smoking.
- Exercise regularly, especially walking.
- Eat a heart-healthy diet.
- Manage diabetes, blood pressure and cholesterol.
These changes can also prevent peripheral artery disease from getting worse.
Medications
Doctors may prescribe medications to help improve blood flow and manage PAD symptoms:
- Lower cholesterol (like statins).
- Control blood pressure.
- Manage diabetes.
- Prevent blood clots (like aspirin or clopidogrel).
- Reduce leg pain (like cilostazol).
Minimally invasive procedures
If lifestyle changes and medications aren’t enough, your doctor may recommend endovascular treatments for peripheral artery disease, such as:
- Angioplasty: A small balloon is used to open the blocked artery.
- Stenting: A tiny mesh tube is placed in the artery to keep it open. Learn more about angioplasty and stenting here.
- Atherectomy: Removes plaque from the artery.
These procedures are done through a small hole in the arteries and are mainly outpatient procedures. Patients go home the same day.
Surgery
In more serious cases, surgery may be needed. One option is bypass surgery. A new path is created for blood to flow around the blocked artery using a blood vessel from another part of your body or a synthetic tube.
What happens if PAD is left untreated?
Without proper treatment, peripheral artery disease can worsen and lead to serious complications. Severe PAD may result in chronic pain, non-healing wounds, infections or even limb amputation. Early diagnosis and consistent treatment are key to maintaining mobility and quality of life.
Take the first step toward better health
PAD is a serious condition, but with the right care, you can manage it and live a full, active life. If you think you might have PAD or want to learn more about your treatment options, click the button below or call 770-219-4000 to schedule an appointment with one of our vascular specialists.
Niraj Parikh, MD, is a vascular surgeon with Northeast Georgia Physicians Group Vascular Center.