What is peripheral artery disease?

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.

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.

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.

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.

• 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.

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.

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.

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.

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).

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.

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.

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.