What is peripheral artery disease?

Peripheral Artery Disease

Peripheral arterial disease (PAD): Overview

Peripheral arterial disease (PAD) occurs when the blood vessels (arteries) that supply blood to the legs, belly, pelvis, arms, or neck get narrow or blocked. This reduces blood flow to that area. The legs are affected most often.

PAD is often caused by fatty buildup (plaque) in the arteries. This buildup is also called "hardening" of the arteries. Your risk of PAD increases if you smoke or have diabetes, high cholesterol, high blood pressure, or a family history of PAD.

Many people don't have symptoms. If you do have symptoms, you may have weak or tired legs, difficulty walking or balancing, or pain. If you have pain, you might feel a tight, aching, or squeezing pain in the calf, foot, thigh, or buttock that occurs during exercise. The pain usually gets worse during exercise and goes away when you rest. If PAD gets worse, you may have symptoms of poor blood flow, such as leg pain when you rest.

Medicine and a specialized exercise program may help relieve symptoms. Medicine and a heart-healthy lifestyle can help slow the progress of the disease and lower your risk of heart attack and stroke. If PAD is severe, a procedure or surgery may be done to improve blood flow.

Peripheral arterial disease (PAD)

Peripheral arterial disease (PAD) is a narrowing or blockage of arteries that causes poor blood flow to your legs or arms.

The most common cause of PAD is the buildup of plaque in blood vessels called "hardening" of the arteries. If you have hardening of the arteries in your legs, you most likely will have it in the arteries of your heart and brain. This increases your chance of having a heart attack or stroke. It can also limit blood flow to the muscles and other tissues of the legs. This can lead to problems with walking or even tissue death.

Treatment for PAD includes ways to relieve symptoms, slow the progress of the disease, and lower your risk of heart attack and stroke.

What are the symptoms of peripheral arterial disease (PAD)?

Many people don't have symptoms. But symptoms can include weak or tired legs or trouble walking or balancing. While you're walking, your calf, thigh, or buttock may have aching or squeezing pain. If PAD gets worse, your legs, feet, or toes might have sores or be cold, numb, or painful. They might change color.

How is peripheral arterial disease (PAD) treated?

Treatment for PAD can help relieve symptoms, slow the progress of the disease, and lower your risk of heart attack and stroke. Treatment options include a heart-healthy lifestyle, a specialized exercise program, and medicine. Some people also have surgery or a procedure called angioplasty to improve blood flow.

How does an exercise program help treat peripheral arterial disease (PAD)?

Specialized exercise programs may help relieve leg pain that occurs with exercise (intermittent claudication) in some people who have PAD. If you have trouble walking because of your symptoms, this type of program may help you walk more easily.

Your doctor may recommend a supervised exercise program. You may work with your doctor or with a therapist at a facility such as a rehab center. In the sessions, you'll walk until the pain starts, then rest until it goes away before continuing. You may be asked to try to walk a little farther each day before resting. Don't try to walk through the pain. The goal is to increase the amount of time you can exercise before the pain starts.

You may start a similar walking program at home (with your doctor's approval). You'll get instructions and guidance from a health professional, but the program isn't supervised. This is called a structured home-based exercise program.

How can you help prevent peripheral arterial disease (PAD)?

  • Try to quit or cut back on using tobacco and other nicotine products. This includes smoking and vaping. Quitting smoking is one of the best things you can do to help prevent PAD. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good. Try to avoid secondhand smoke too.
  • Eat a heart-healthy diet that includes vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit alcohol, sodium, and sugar.
  • Get regular exercise. Try for 30 minutes on most days of the week. You may want to walk, swim, bike, or do other activities. Ask your doctor what level of exercise is safe for you.
  • Stay at a weight that's healthy for you. Talk to your doctor if you need help losing weight.
  • Try to get 7 to 9 hours of sleep each night.
  • Manage other health problems, including diabetes, high blood pressure, and high cholesterol. If you think you may have a problem with alcohol or drug use, talk to your doctor.

How is peripheral arterial disease (PAD) diagnosed?

Your doctor will check the pulse and blood pressure in different areas of your body. Your doctor may also look at the skin of your legs and feet to check for changes caused by poor blood flow. You may have a Doppler ultrasound, which measures blood flow in the arteries.

How is medicine used to treat peripheral arterial disease (PAD)?

Medicines are used to treat symptoms, slow the progress of the disease, and lower your risk of heart attack and stroke.

Cilostazol (Pletal) treats leg pain that happens when you are active (intermittent claudication).

Other medicines can help lower your risk of heart attack and stroke. These include:

  • Aspirin and other blood thinners. They help prevent blood clots.
  • Statins and other medicines. They help lower cholesterol levels.
  • Medicines to control high blood pressure.
  • Medicines to control diabetes.

How can you care for yourself when you have peripheral arterial disease (PAD)?

You can help manage PAD by having a heart-healthy lifestyle, managing other health problems, and trying to quit or cut back on smoking. Take medicine as prescribed. Take good care of your feet. Watch for new and worse symptoms, and know when to call your doctor.

How is a procedure or surgery used to treat peripheral arterial disease (PAD) of the legs?

A procedure called angioplasty or a bypass surgery is done to improve blood flow to the legs and feet. This can relieve symptoms (intermittent claudication) and may help you walk farther without pain.

An angioplasty or surgery is also done to treat severely limited blood flow to a leg or foot. This limited blood flow can lead to open sores and serious skin, bone, and tissue problems (gangrene).

During an angioplasty, a doctor uses a catheter inside blood vessels to widen the narrow parts.

Bypass surgery redirects blood through a grafted blood vessel. This bypasses the blood vessel that is damaged. Surgeries include:

  • Aortobifemoral bypass.
  • Femoropopliteal (fem-pop) bypass.
  • Femoral-tibial bypass.

A surgery called endarterectomy is done to remove plaque from the blood vessel. It's most often done on the large artery in your groin and upper thigh area (femoral artery).

What increases your risk for peripheral arterial disease (PAD)?

Many things can increase your risk for atherosclerosis and PAD. These include:

  • Smoking.
  • Diabetes.
  • High cholesterol.
  • High blood pressure.
  • Not being active regularly.
  • A family history of atherosclerosis or coronary artery disease.
  • Being African American.

The risk for PAD also increases with age.

People who have the disease in one part of the body are likely to have it in other places, including the legs.

What is peripheral arterial disease (PAD)?

Peripheral arterial disease (PAD) is narrowing or blockage of arteries that causes poor blood flow to your arms and legs. PAD is most common in the legs.

PAD is often caused by fatty buildup (plaque) in the arteries. Over time, plaque builds up in the walls of the arteries, including those that supply blood to your legs. This can limit blood flow to the muscles and other tissues of the legs. PAD can make it hard for you to walk. It can also lead to tissue death. Sometimes part of the leg must be removed by surgery (amputation).

If you have PAD, you're also likely to have plaque in other arteries in your body. This raises your risk of a heart attack and stroke.

Peripheral arterial disease is also called peripheral vascular disease.

What causes peripheral arterial disease (PAD)?

The most common cause of PAD is the buildup of plaque inside of arteries, including the ones that supply blood to your legs. This buildup leads to poor blood flow. Smoking, diabetes, high cholesterol, and high blood pressure all contribute to plaque buildup.

Peripheral arterial disease (PAD): When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.

After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

  • You have sudden symptoms in your leg or foot such as severe pain, numbness, weakness, tingling, cool skin, or skin color changes. Your skin may be pale, bluish, or purplish.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.

Call your doctor now or seek immediate medical care if:

  • You have leg pain that does not go away even if you rest.
  • Your leg pain changes or gets worse. For example, if you have more pain with normal activity or the same pain with decreased activity, you should call.
  • You have cold, tingly, weak, or numb feet or toes.
  • You have leg or foot sores that are slow to heal.
  • The skin on your legs or feet changes color. It may be pale, bluish, or purplish.
  • The skin on your legs or feet has blisters or looks shiny.
  • You have an open sore on your leg or foot that is infected. Signs of infection include:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the sore.
    • Pus draining from the sore.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.