ProVas Labs

Peripheral Artery Disease (PAD)

What is Peripheral Artery Disease (PAD)?

Peripheral arterial disease (PAD) is narrowing or blockage of the arteries leading to decreased blood flow to your legs or feet. When a person develops peripheral arterial disease, their limbs do not receive enough blood flow to keep up with demand. PAD usually occurs in the legs, and it can cause symptoms such as leg pain when walking.

People who develop PAD commonly suffer from atherosclerosis, also known as “hardening of the arteries.” This occurs when plaque (fatty material) builds up on the inner walls of the arteries. This narrows and clogs the arteries and decreases blood flow. In the legs, this can lead to pain and cramping when walking, and later can result in pain in the toes and feet when a person is resting. This is because the arteries are now unable to deliver enough blood to the feet. In its most advanced stage, this can lead into tissue necrosis, even possible amputation.

What are the symptoms associated with Peripheral Artery Disease (PAD)?

When a person develops peripheral arterial disease, they may not have any symptoms, or have mild symptoms such as leg pain when walking, what is known as claudication.

Claudication symptoms include muscle pain or cramping in the legs that is triggered by use of the limb, such as walking. The symptoms usually disappear after a few minutes of rest. The location of the pain depends on the location of the clogged or narrowed artery. Pain is most common in the calves.

The severity of the claudication can vary from mild discomfort to debilitating pain that keeps the person from doing things such as walking the dog.

Some symptoms associated with peripheral arterial disease include:

  • Painful cramping in one or both of your hips, thighs, or calf muscles after certain activities, such as climbing stairs
  • Leg numbness
  • Leg weakness
  • Sores on your toes, feet, or legs that won’t heal
  • Coldness in your lower leg or foot, especially when contrasted with the other leg
  • Color change in your legs
  • Shiny skin on your legs
  • No pulse or a faint pulse in your legs or feet


Some of these symptoms may indicate the patient is in danger of losing possible toes or even a foot. The blockage needs may need to be addressed.

PAD diagnosis begins with a medical history and physical examination. Your health care provider will also ask about symptoms and check the arterial pulse in your legs.
Your physical exam may include:

  • Ankle-brachial Index (ABI): This painless exam compares the blood pressure in your lower legs to the blood pressure in your arms. It takes only a few minutes and can be performed in office as part of a routine exam.


If your ABI is normal, but you have certain medical conditions like diabetes or kidney disease, you may still need additional testing. If your ABI is abnormal, your doctor may recommend one of these additional tests:

  • Arterial Duplex Ultrasound: This non-invasive test visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of blockage or decreased flow.
  • Computed Tomographic Angiography (CTA): This non-invasive test uses X-ray and contrast dye to create pictures of blood vessels in the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.
  • Magnetic Resonance Angiography (MRA): This test provides cross-sectional images like a CT without using X-rays, and can provide better information regarding flow dynamics.
  • Angiogram: An angiogram is imaging of an artery obtained with a small amount of contrast dye and/or carbon dioxide. This procedure is performed under conscious sedation, which will make you comfortable during the procedure. The imaging obtained during an angiogram can be both diagnostic and/or for treatment. This is done by making a small nick in the skin at the access site, usually the groin. A thin, flexible catheter is then placed into the artery for imaging and potential treatment. This imaging allows our Vascular Interventional Radiologists to see inside of an artery. They can then assess potential obstructions. There are a variety of treatments that can be performed during an angiogram including angioplasty, atherectomy, and/or stent placement. 
What happens if I leave my peripheral artery disease untreated?

Once your arteries have narrowed due to atherosclerosis, there is the risk of developing more serious conditions like:

  • Ulcer formation, non-healing wounds.
  • Claudication    A condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries. 
  • Critical limb ischemia — Critical limb ischemia occurs when the injuries or infections progress and cause tissue death. This can lead to amputation.