What is peripheral artery disease (PAD)?
Peripheral artery disease (PAD) occurs when the arteries that carry blood to your legs, abdomen, and arms become narrowed, reducing blood flow. The narrowing occurs when plaque, a fatty substance, builds up inside these arteries.
Many people with peripheral artery disease (also called peripheral arterial disease or peripheral vascular disease) have discomfort or pain when walking, called claudication. The reduced blood flow may damage skin, muscle, and other tissues. In severe cases, blood clots or other problems can block arteries completely and even cause limb loss. Penn Medicine’s vascular specialists, including vascular surgeons, cardiologists, and interventional radiologists, provide the latest treatment approaches to help prevent these outcomes.
What are typical symptoms of peripheral artery disease?
Up to 40 percent of people with peripheral artery disease have no symptoms, even though the condition can still affect blood flow. Others have mild symptoms that can worsen over time. If left untreated, PAD can lead to serious health problems. Watch for symptoms like:
- Calf, hip, or thigh cramping after walking, climbing stairs, or exercising
- Erectile dysfunction, especially if you have diabetes
- Reduced toenail growth or hair growth on the legs
- Cold feet or lower legs
- Changes in skin color on the legs
- Sores that are slow to heal on the legs, feet, or toes
- Weakness or numbness in the legs
What causes peripheral artery disease
Peripheral artery disease happens when plaque builds up in your blood vessels, causing them to narrow and harden (atherosclerosis).
Risk factors for peripheral artery disease include:
- Diabetes
- High blood pressure or high cholesterol
- Inactive lifestyle
- Chronic kidney disease or kidney failure
- Obesity
- Smoking or tobacco use
- Age (50 and older)
- Black racial background
How is peripheral artery disease diagnosed?
Diagnosing peripheral artery disease usually begins with a physical exam. Your care provider will talk with you about your symptoms and your lifestyle. They may also order blood tests to check your cholesterol, blood fats (triglycerides), and blood sugar. You may have testing in your provider's office or in our vascular testing and diagnosis labs.
To test your circulation, your provider may start with an ankle-brachial index (ABI) test, which compares blood pressure in your arms and ankles to see how well blood flows to your legs. From there, they may also order imaging tests.
How is peripheral artery disease treated?
The goal of peripheral artery disease treatment is to improve circulation, manage symptoms, and reduce your risk of complications. Your care team may recommend lifestyle changes, medications, exercise therapy, or procedures to improve blood flow, depending on your symptoms and how PAD affects your health.
If those steps aren’t enough, Penn Medicine offers minimally invasive procedures and surgery. These include advanced options like intravascular lithotripsy, which uses sound waves inside the artery to break up hard calcium deposits before placing a stent.
Slowing the progression of PAD
Adopting healthy habits can have a big impact on your symptoms and overall vascular health. Your care team may recommend:
- Improve your diet: Add more vegetables, whole grains, nuts, seeds, fish, and poultry, and cut back on salt, sugar, processed foods, and red meat.
- Manage diabetes: If you have diabetes, controlling your blood sugar is important. Talk with your care team about the best steps to take.
- Stay or become active: Activity can be challenging with PAD, since walking can be painful. Your care team may recommend a supervised or structured exercise program to help improve your walking ability.
- Stop smoking: Quitting can slow PAD’s progression. Our compassionate, effective smoking cessation program can help.
A team approach to peripheral artery disease
PAD can affect more than your legs. It can also raise your risk of heart attack and stroke, and severe disease can affect wound healing and limb health. That’s why Penn Medicine brings together vascular and heart specialists, along with podiatry, wound care, and rehabilitation teams, so your care matches how PAD affects you.
For people with severe PAD or wounds that aren’t healing, Penn Advanced Limb Preservation brings these specialties together to improve blood flow, support wound healing, and help prevent limb loss. The program also offers advanced endovascular and surgical procedures, vascular testing, and access to clinical trials.