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Peripheral Artery Disease
(PAD; Peripheral Vascular Disease; PVD; Arteriosclerosis Obliterans)
Peripheral artery disease (PAD) is a condition that leads to a decrease of blood flow to the arms and legs.
PAD is most often caused by a narrowing of blood vessels that supply blood to the arms and legs. The narrowing is usually caused by a buildup of plaque called atherosclerosis . The build up occurs over long periods of time and is increased with:
Other conditions that can slow blood flow include blood clots and inflammation of the blood vessels. Certain conditions like congenital heart disease can also decrease the amount of oxygen rich blood that reaches the arms and legs.
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PAD is more common in men and in people over 50 years of age. Other factors that may increase your chances of PAD:
Symptoms of PAD will depend on the area that is most affected. Common symptoms include:
- Pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s) brought on by exercise that goes away when resting
- Numbness and pain of the legs or feet at rest
- Cold hands, legs, or feet
- Loss of hair on the legs and/or feet
- Paleness or blueness of the legs
- Weak or absent pulse in the leg
- Sores, ulcer, or infection of the feet and legs that heal slowly
- Erectile dysfunction
- Swelling in lower extremities
- Muscle atrophy—loss of muscle
You will be asked about your symptoms and medical history. A physical exam will be done.
During the exam, your doctor may do the following:
- Check the strength of the pulse in the legs
- Use a stethescope to listen for abnormal sounds in leg arteries or the abdomen
- Check blood pressure in the leg
If the doctor suspects a change in blood flow, other tests may be done to confirm change or look for causes. Images of blood vessels can be done with:
Your heart activity may need to be tested. This can be done with an ECG .
Early treatment can slow or stop the disease. Treatment options include the following:
Certain lifestyle changes can improve the health of your heart and blood vessels. Steps that may help you slow or even reverse PAD include:
Medications that may help improve blood flow include:
- Blood thinners to reduce blood clots
- Statins to lower cholesterol
- Vasodilators to widen arteries
Pain medication may also be needed to help manage discomfort.
If blood flow is very poor, a procedure may be needed to quickly increase blood flow. Options include:
Surgery may be needed to open arteries that are severely blocked. Options include:
- Endarterectomy —the lining of the artery is removed, along with plaque build up
- Bypass surgery—a vein from another part of the body or a graft is used to send blood flow around the blockage
A heart healthy lifestyle can decrease the risk of PAD. General steps include:
- Regular physical activity
- Eating a healthful diet
- Quitting or not starting smoking
- Working with your medical team to manage any related conditions
American Heart Association
Family Doctor—American Academy of Family Physicians
Canadian Society for Vascular Surgery
Heart and Stroke Foundation of Canada
Hennon DR, Siano KA. Diagnosis and treatment of peripheral arterial disease. Am Fam Physician. 2013;88(5):306-310.
Mahmud E, Cavendish JJ, Salami A. Current treatment of peripheral arterial disease: role of percutaneous interventional therapies. J Am Coll Cardiol. 2007;50(6):473-490.
Peripheral artery disease. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/peripheral-artery-disease. Accessed March 1, 2018.
Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities . Updated January 26, 2018. Accessed March 1, 2018.
Prevention and treatment of PAD. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/VascularHealth/PeripheralArteryDisease/Prevention-and-Treatment-of-PAD%5FUCM%5F301308%5FArticle.jsp#.WphMNWrwZQI. Updated February 20, 2018. Accessed March 1, 2018.
11/18/2011 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities : Rooke TW, Hirsch AT, Misra S, et al. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124(18):2020-2045.
6/29/2018 DynaMed Plus Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Beckman JA, Duncan MS, Alcorn CW, et al. Association of HIV infection and risk of peripheral artery disease. Circulation. 2018 Mar 13 [Epub ahead of print].
- Reviewer: EBSCO Medical Review Board Michael J. Fucci, DO, FACC
- Review Date: 03/2018
- Update Date: 06/29/2018