What is peripheral artery disease?
Peripheral artery disease (PAD) is a condition that affects how blood travels from the heart to the body’s organs and extremities. While cardiovascular disease is often linked to the heart, PAD affects circulation in the hands, arms, legs, feet and all of your body’s organs.
As with other heart and vascular conditions, you can improve PAD with lifestyle changes including exercise, dietary changes and stopping tobacco usage. You can also talk to your vascular specialist about medications or minimally invasive procedures to treat PAD, if needed.
Peripheral artery disease symptoms
When blood flow to your legs is severely reduced, you may experience discomfort when walking, climbing stairs or exercising. You might also notice painful muscle cramping, aching, discomfort or fatigue in your buttocks, hips, thighs, calves or feet that improve with rest, a condition called claudication.
In PAD’s early stages, this pain typically goes away with rest and stopping the activity. However, in severe cases, your leg pain may persist after finishing exercise.
Because PAD reduces blood flow to your extremities, you might also experience additional symptoms, including:
- Foot or toe pain at rest that often disturbs your sleep
- Gangrene
- Hair loss on the affected limb
- A significant difference in the temperature of one lower leg or foot compared with the other
- Smooth, shiny skin
- Skin sores or wounds on the feet or toes that heal slowly or not at all
However, not everyone with PAD experiences symptoms. Knowing if you’re at risk for the condition can help guide conversations with your physician about screening and prevention. You may be referred to a vascular surgeon for further evaluation.
Peripheral artery disease causes
Peripheral artery disease is often caused when the arteries that carry blood throughout your body become narrowed or clogged with fatty deposits known as plaque. When plaque builds up, the arteries harden and narrow, a process called atherosclerosis.
PAD may develop in the arteries in the legs because atherosclerosis reduces blood flow, resulting in poor circulation in the legs and feet. PAD can affect other arteries that carry blood to the brain, arms, kidneys and stomach.
PAD risk factors
PAD shares many of the same risk factors as other cardiovascular diseases. Smoking is a leading risk factor because it promotes plaque buildup, constricts blood vessels and causes blood to clot.
Fortunately, you can address or manage all these risk factors by quitting smoking, exercising and eating a heart-healthy diet low in sugar, fat and salt.
Your risk is also higher if you have any of the following conditions:
What are the complications of peripheral artery disease?
If left untreated, peripheral artery disease can cause discomfort, tissue damage and increase your risk of developing serious conditions such as:
- Claudication: Muscle pain and cramping in your feet and legs due to reduced blood supply.
- Critical limb ischemia: This is a condition where, as your arteries become blocked, you experience chronic pain and can develop non-healing wounds and ulcers on your feet.
- Stroke and heart attack: With PAD, your risk of heart attack and stroke increases due to reduced blood flow to your heart and brain.
How to diagnose PAD
Vascular specialists use many diagnostic techniques to identify PAD, most of which are noninvasive imaging tests and are painless.
Physical and medical exam
Your doctor will carry out a physical exam and look at your medical history to see if you are at risk of PAD.
Ankle-brachial index (ABI)
The most common PAD diagnosis method for evaluation of blood flow in the legs is the ankle-brachial index, which compares blood pressure in the ankles with blood pressure in the arm to evaluate blood flow through the body.
Imaging tests
Based on the results of your ankle-brachial index, your vascular specialist may recommend another more advanced imaging exam to confirm a diagnosis of PAD.
- Ultrasound: An ultrasound uses sound waves to create images of blood vessels, so it can be used to assess blood flow and any narrowing or blockages in your arteries.
- Angiography: This imaging test uses both an X-ray and contrast dye to make arteries visible to your doctor. This allows your healthcare team to pinpoint any blockages.
Peripheral artery disease treatments
Peripheral artery disease treatment frequently starts with a combination of lifestyle changes and medications.
Lifestyle changes
A healthy lifestyle helps reduce your risk and manage early symptoms of PAD.
- Follow a heart-healthy diet. Include plenty of fruits, vegetables and low-fat dairy products and avoid foods high in saturated fat and cholesterol.
- Quit smoking.
Exercise
Incorporate regular physical activity, like walking, into your routine for 30 minutes at least three or four times per week. Walking can notably enhance your quality of life. Along with relieving PAD symptoms, a consistent walking regimen will:
- Help you stay active.
- Help control blood sugar, blood pressure, cholesterol and body weight, all of which can increase your risk of PAD complications.
- Lower your chances of having a heart attack or stroke
Foot care
If you have diabetes and PAD, talk with your physician about proper foot care.
PAD reduces blood flow to your feet, and minor problems, such as cuts, sores and blisters, may not heal quickly. Diabetes may complicate foot problems because it can reduce blood circulation in your feet and legs and can cause nerve damage, or diabetic neuropathy. Diabetic neuropathy can cause you to have decreased sensation in your feet, and you may not feel a sore or a blister developing on your foot.
You can prevent minor foot injuries from turning into infections by:
- Always wearing shoes, socks or slippers, even indoors
- Cleaning your feet daily and inspecting them for cuts, blisters, sores, callouses and other injuries
- Cutting toenails in a straight line
- Wearing properly fitting shoes
- Seeking professional care for corn and callous removal
Supervised exercise therapy
If you have PAD caused by atherosclerosis, you may be eligible to receive supervised exercise therapy, which helps improve your ability and confidence to perform daily activities.
Medications
In addition to lifestyle changes and exercise therapy, your vascular specialist may prescribe medications to help manage chronic conditions, such as blood pressure, cholesterol and diabetes.
You may also need to take blood thinners to help prevent the formation of blood clots. When plaque builds up in your arteries, that plaque can break off, causing blood clots to form and increasing your risk of heart attack and stroke.
Surgery and other procedures
Conservative treatments may be enough to control PAD and even improve symptoms. But you may need angioplasty, stents, or in more advanced cases, surgery if your leg arteries are severely clogged or narrowed. These treatment options can improve blood flow to your extremities.
Some of the most common procedures to treat PAD are:
- Angioplasty: Angioplasty uses a tiny, balloon-tipped catheter inserted into the blocked artery to open it up. Your doctor inserts the catheter into an artery and guides it to the blocked area of the artery. Once the catheter is in place, they expand the balloon. A wire-mesh tube, called a stent, is often placed in the newly opened artery through the catheter to maintain normal blood flow.
- Stenting: Vascular surgeons can perform stenting for PAD that affects the upper and lower extremities. The procedure is often used when a blockage causes PAD. Your vascular surgeon will place a stent into the artery to keep it open, rerouting the blood supply around the blocked artery.
- Bypass surgery: In this treatment, vascular surgeons transplant a vein from another part of the body, or use a man-made tube, and attach it to the blocked artery above and below the blockage. Blood can then flow around the blockage through the transplanted artery.
Find a location near you
Between lifestyle changes, medications and surgery, you can manage PAD successfully with the help of a skilled vascular healthcare team. The specialists at our heart and vascular centers coordinate care with your other physicians so you can get the care you need close to home.
Baylor Scott & White All Saints Medical Center - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White Clinic - Temple
2401 S 31st St , Temple, TX, 76508- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Heart and Vascular Hospital - Dallas
621 N Hall St , Dallas, TX, 75226
Baylor Scott & White Heart and Vascular Hospital - Fort Worth
1400 8th Ave Bldg A, 6th Floor, Fort Worth, TX, 76104
Baylor Scott & White Medical Center - Centennial
12505 Lebanon Rd , Frisco, TX, 75035
Baylor Scott & White Medical Center - Frisco
5601 Warren Pkwy , Frisco, TX, 75034
Baylor Scott & White Medical Center - Grapevine
1650 W College St , Grapevine, TX, 76051
Baylor Scott & White Medical Center - Hillcrest
100 Hillcrest Medical Blvd , Waco, TX, 76712
Baylor Scott & White Medical Center - Irving
1901 N MacArthur Blvd , Irving, TX, 75061
Baylor Scott & White Medical Center - Lake Pointe
6800 Scenic Dr , Rowlett, TX, 75088
Baylor Scott & White Medical Center - Lakeway
100 Medical Pkwy , Lakeway, TX, 78738
Baylor Scott & White Medical Center - Marble Falls
810 W State Hwy 71 , Marble Falls, TX, 78654
Baylor Scott & White Medical Center - McKinney
5252 W University Dr Highway 380 at Lake Forest Drive, McKinney, TX, 75071
Baylor Scott & White Medical Center - Plano
4700 Alliance Blvd , Plano, TX, 75093
Baylor Scott & White Medical Center - Round Rock
300 University Blvd , Round Rock, TX, 78665
Baylor Scott & White Medical Center - Sunnyvale
231 S Collins Rd , Sunnyvale, TX, 75182
Baylor Scott & White Medical Center - Temple
2401 S 31st St , Temple, TX, 76508
Baylor Scott & White Medical Center - Waxahachie
2400 N Interstate 35E , Waxahachie, TX, 75165
Baylor Scott & White Specialty Clinic - Killeen Hemingway
2405 S Clear Creek Rd , Killeen, TX, 76549- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Specialty Clinic - Lakeway
200 Medical Pkwy , Lakeway, TX, 78738- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Hospital - Denton
2801 S Mayhill Rd , Denton, TX, 76208
Baylor Scott & White The Heart Hospital - McKinney
5268 W University Dr , McKinney, TX, 75071
Baylor Scott & White The Heart Hospital - Plano
1100 Allied Dr , Plano, TX, 75093
Baylor Scott & White Vascular and Vein Clinic - Austin
2217 Park Bend Dr Ste 230, Austin, TX, 78758- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Vascular Surgery Specialists - Fort Worth
1250 8th Ave Ste 200, Fort Worth, TX, 76104- Monday: 8:30 am - 4:30 pm
- Tuesday: 8:30 am - 4:30 pm
- Wednesday: 8:30 am - 4:30 pm
- Thursday: 8:30 am - 4:30 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White Vascular Surgery Specialists - Grapevine
2020 W State Hwy 114 Ste 200, Grapevine, TX, 76051
Baylor Scott & White Vascular Surgery Specialists - Mansfield
1776 N US 287 Ste 220, Mansfield, TX, 76063