Peripheral Arterial Disease (PAD)

Michael N. Tameo, M.D.
Ronald L. Nath, M.D. , F.A.C.S.

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Peripheral arterial disease (PAD, or PVD for peripheral vascular disease) refers to the build-up of atherosclerotic (cholesterol) plaque within the peripheral arteries such that symptoms occur from lack of blood flow. The arteries in the legs are most commonly affected. The symptoms can include claudication (pain with walking), pain at rest in the feet or toes, and tissue loss, which includes ulcers, wounds, gangrene, and infection.

Complications from PAD include acute thrombosis (occlusion from blood clot formation) and embolism, which is when thrombus (blood clot) or plaque from higher up in an artery or the heart breaks loose and lodges itself into an artery further downstream. These complications can cause sudden severe pain, limb-threatening ischemia, and gangrene and/or infection. This can result in loss of toes or limbs.

Diagnosis and management of PAD requires a thorough history and physical exam by a vascular surgeon. An ultrasound and/or non-invasive arterial study, which we perform at our office in our accredited non-invasive vascular lab, is often required. Patients can receive the required test and be seen by their vascular surgeon at the same visit. Occasionally, a computed tomography (CT) scan, magnetic resonance imaging (MRI) study, or arteriogram (injection of contrast dye into the arteries) is required.

Treatment of symptomatic PAD may involve medical therapy along with an exercise regimen, minimally invasive (endovascular) treatment with balloon angioplasty and/or stenting, or open surgical reconstruction with a graft.