Peripheral Arterial Disease

What is peripheral artery disease?

Peripheral artery disease (PAD) is narrow, weak, or blocked arteries outside of your heart and brain. PAD is usually the result of a buildup of fat and cholesterol, also called plaque, along your artery walls. Inflammation, a blood clot, or abnormal cell growth could also block your arteries. PAD prevents normal blood flow to your legs and arms. You are at risk of an amputation if poor blood flow keeps wounds from healing or causes gangrene (tissue death). Without treatment, PAD can also cause a heart attack or stroke.

What increases my risk for PAD?

• Smoking cigarettes
• Diabetes
• High blood pressure
• High cholesterol
• Age older than 40 years
• Heart disease or a family history of heart disease

How is PAD diagnosed?

PAD can be diagnosed a couple of ways:

• Angiography: Angiography is a test that shows images of the arteries in your arms and legs. You are given a dye to help the arteries show up better in the pictures. The pictures will be taken with an MRI or CT scan. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.
• Doppler ankle brachial index (ABI): ABI is a test that compares blood pressure in your ankles to blood pressure in your arms. This helps your healthcare provider know how well blood is flowing through the arteries in your legs.
• Treadmill exercise test: A treadmill exercise test is a test that measures blood flow through your arteries before and after exercise.

How is PAD treated?
Treatment can help reduce your risk of a heart attack, stroke, or amputation. You may need more than one of the following:

• Antiplatelet medicine: Antiplatelet medicine, such as aspirin, helps prevent blood clots and reduces the risk of a heart attack or stroke.
• Exercise rehabilitation: This is a program to increase how far you can walk without pain. Healthcare providers will help you safely walk or do strength training exercises three times a week for 30 to 60 minutes. You will do this for several months, then transition to walking on your own. This program helps you stay active in normal daily activities and may prevent disability caused by PAD.
• Angioplasty: Angioplasty is a procedure to open your artery so blood can flow through normally. A thin tube called a catheter is used to insert a small balloon into your artery. The balloon is inflated to open your blocked artery, and then removed. A tube called a stent may be placed in your artery to hold it open.
• Bypass surgery: Bypass surgery is used to make a new connection to your artery with a vein from another part of your body, or an artificial graft. The vein or graft is attached to your artery above and below your blockage. This allows blood to flow around the blocked portion of your artery.

How can I manage PAD?

• Do not smoke. If you smoke, it is never too late to quit. Quitting smoking may reduce your pain and other symptoms. It also helps reduce your risk that PAD will lead to a stroke, heart attack, or amputation. Ask your healthcare provider for information if you need help quitting.
• Manage other health conditions. Take your medicines as directed. Follow your healthcare provider’s instructions if you have high blood pressure or high cholesterol. Perform foot care and check your blood sugar levels as directed if you have diabetes.
• Eat heart healthy foods. Eat whole grains, fruits, and vegetables every day. Limit salt and high-fat foods. Ask your healthcare provider for more information on a heart healthy diet. Ask if you need to lose weight. Your healthcare provider can help you create a healthy weight-loss plan.

When should I seek immediate care?

• You have sores or wounds that will not heal.
• You notice black or discolored skin on your arm or leg.
• Your skin is cool to the touch.

When should I contact my healthcare provider?

• You have leg pain when you walk 1/8 mile (200 meters) or less, even with treatment.
• Your legs are red, dry, or pale, even with treatment.
• You have questions or concerns about your condition or care.