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Peripheral Artery Disease (PAD)


Peripheral arterial disease (PAD) occurs when plaque buildup reduces blood flow through the arteries. It often happens in the legs and feet, but can also occur elsewhere in the body. If this buildup occurs in the carotid artery (a large artery in the neck), it can be a major contributor to stroke.

Causes and Risk Factors for Peripheral Artery Disease

Peripheral arteries deliver oxygen-rich blood to the tissues outside the heart. As you age, your arteries become stiffer and thicker. In addition, risk factors, such as smoking and high cholesterol, can damage the artery lining. This allows plaque (a buildup of fat and other materials) to form within the artery walls. The buildup of plaque narrows the space inside the artery and sometimes blocks blood flow.

Other factors that increase your chances of developing the disease include:

  • Smoking
  • Diabetes
  • High blood pressure
  • High cholesterol or triglycerides
  • High levels of homocysteine, an amino acid in your blood
  • Weighing over 30 percent more than your ideal weight

Symptoms of PAD

Symptoms of peripheral artery disease include:

  • Intermittent claudication, or painful cramping in your hip, thigh or calf muscles after walking or climbing stairs
  • Leg numbness or weakness
  • Coldness in your lower leg or foot
  • Sores on your toes, feet or legs that won't heal
  • A change in the color of your legs
  • Hair loss on your feet and legs
  • Changes in your toenails

If peripheral artery disease progresses, you may even experience ischemic rest pain, or pain that occurs when you're at rest or when you're lying down. It may be intense enough to disrupt sleep.

Diagnosing PAD

Your healthcare provider will perform a physical exam, including a medical history and questions about your symptoms.

The provider may check your pulse in the areas that are affected and perform the following tests:

  • Aortography to see blockages in your large arteries
  • Blood pressure measured in arms and legs for comparison
  • Peripheral angiography to see where blood flow may be blocked

Treating Peripheral Artery Disease at Dignity Health Heart and Vascular Institute

If PAD is detected early, you can your disease through lifestyle changes such as:

  • Exercising regularly
  • Losing weight
  • Quitting smoking

Your physician may also recommend medication, such as:

  • Cholesterol-lowering drugs (statins)
  • Blood pressure-lowering medications
  • Medications that reduce blood clotting to minimize the chances of blockages in your narrowed arteries
  • Other medications that may be prescribed to improve the distance you can walk without discomfort or pain

In more severe cases, you may also require surgical treatments. The choice of treatment depends on the extent of blockages as well as other factors. Your vascular surgeon will help you determine the best option for your particular situation. Some surgical treatments you may explore include:

  • Peripheral angioplasty, a procedure that helps open blockages in peripheral arteries
  • Peripheral artery bypass, which is surgery using a graft to reroute blood around a blockage in your artery
  • Endarterectomy a procedure that allows your surgeon to remove plaque from your artery

In extreme cases and as a last resort, your surgeon may recommend amputating your lower leg or foot. This procedure would only be performed when circulation is severely reduced and cannot be improved by any of the methods already discussed.

Managing PAD

Additionally, lifestyle changes may help you manage your PAD, including:

At Dignity Health Heart and Vascular Institute of Greater Sacramento, we offer a number of preventative health programs and tools for our patients. Find out more about how we can help you Stay Heart Healthy.