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Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD) treatment helps relieve leg pain when walking and protect your circulation, starting with a thorough evaluation and a step-by-step plan that can include exercise therapy, medications, and minimally invasive procedures for select patients. PAD is a circulation problem where the arteries that carry blood to your legs become narrowed or blocked, most often from atherosclerosis, or plaque buildup inside the artery. When less blood gets to your leg muscles, walking can start to hurt, and wounds can heal more slowly. PAD is also a warning sign that similar plaque may be present in heart and brain arteries too. (1,2)

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Older man stopping on a walk with calf pain, a common symptom of peripheral artery disease

At VidaVascular, a vascular and interventional care practice, patients can be evaluated for PAD and discuss treatment options in a patient centered, step by step way, with answers about leg pain, reduced walking endurance, or foot symptoms that do not feel normal.

Not sure whether your leg pain is PAD? Read our guide to leg pain when walking, including how PAD pain differs from other causes and who should be checked.

What is Peripheral Artery Disease (PAD), and what causes it?

PAD is narrowing of the arteries, most commonly in the legs. The most common cause is atherosclerosis. (1,2)

Common PAD risk factors include:

  • Smoking (current or past)
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Kidney disease
  • Older age
  • Family history of vascular disease (1,2)

PAD is common and often underdiagnosed because symptoms can be mild, mistaken for “just aging,” or show up as hip, thigh, or calf discomfort that people blame on joints or sciatica. (1,2)

What are the most common PAD symptoms, and what symptoms are an emergency?

The classic PAD symptom is claudication, which means muscle pain or tightness with walking that improves with rest. It is not the same as joint pain. It feels more like the muscle is running out of oxygen. (1,2)

Common PAD symptoms:

  • Calf, thigh, or buttock pain with walking that stops with rest
  • Leg fatigue or heaviness when walking
  • Cold feet or one foot that feels colder than the other
  • Numbness or weakness in the legs
  • Slow healing sores on toes, feet, or ankles
  • Shiny skin, hair loss on legs, thick toenails (signs of reduced circulation) (1,2)

Emergency symptoms that need urgent care right away

  • Sudden severe leg pain
  • A leg or foot that becomes cold, pale, or blue
  • New inability to move toes or foot
  • Sudden numbness with worsening pain

These can be signs of acute limb ischemia, which means a sudden loss of blood flow. It is time sensitive. (1)

How is PAD diagnosed, and what tests might VidaVascular use?

Diagnosis usually starts with symptoms, a pulse exam, and simple circulation tests. A key first test is the ankle brachial index (ABI), which compares blood pressure at the ankle to blood pressure in the arm. If the ankle pressure is much lower, it suggests blocked leg arteries. (1,2,3)

Common PAD tests include:

  • ABI test (quick, noninvasive) (1–3)
  • Toe brachial index (helpful when ABI is less reliable, such as with diabetes or stiff arteries) (1)
  • Duplex ultrasound to look at blood flow and narrowing (1,2)
  • CTA or MRA imaging in some cases when more detail is needed for planning care (1)

A good evaluation also checks the bigger picture, because PAD care is not only about legs. It is also about reducing heart attack and stroke risk. (1,2)

What treatments help PAD, and what options are offered at VidaVascular?

PAD treatment usually has two goals:

  1. Help you walk and feel better
  2. Lower the risk of heart attack, stroke, and limb complications (1,2)

Treatment options often include:

  • Walking based exercise therapy, especially supervised exercise therapy for claudication (4,5)
  • Medications to reduce clotting risk and protect arteries (for example, antiplatelet therapy and cholesterol lowering therapy) (1,2)
  • Smoking cessation support if applicable (1,2)
  • Diabetes and blood pressure control (1,2)
  • Minimally invasive or surgical procedures may be discussed for select patients with lifestyle limiting symptoms or more severe disease (1,2)

Research supports structured exercise as a powerful treatment for improving walking ability in claudication, and some studies show added improvement when exercise is paired with revascularization in selected cases. (4,5)

VidaVascular offers PAD evaluation and can discuss these options based on your symptoms, test results, and goals, without rushing you into a one size fits all plan.

What can I do at home to slow PAD progression and protect my legs?

Small daily actions make a big difference with PAD, because PAD is strongly tied to overall artery health. (1,2)

Practical steps that help:

  • Walk regularly (as guided by your clinician), because walking trains your muscles to use oxygen more efficiently (4)
  • Take prescribed medications consistently, especially cholesterol and antiplatelet therapy when indicated (1,2)
  • Stop smoking, since smoking is one of the strongest drivers of PAD progression (1,2)
  • Check your feet daily, especially if you have diabetes: look for blisters, cuts, redness, or color change, and do not ignore a wound that is not improving (1)
  • Call early for new symptoms, like new rest pain, toe discoloration, or a sore that is not healing

Some patients with PAD also benefit from specific antithrombotic strategies to lower limb and cardiovascular events, depending on their risk profile and clinical situation. (6,7)

Why choose VidaVascular for Peripheral Artery Disease (PAD)?

PAD is treatable, but it is not something to brush off as “just getting older.” If walking is painful, your feet stay cold, or you have a sore that will not heal, it is worth getting checked. VidaVascular provides Peripheral Artery Disease evaluation and treatment options, with a focus on clear explanations, evidence based care, and a plan that fits your life.

If you are looking for PAD testing, ABI exams, or a leg circulation evaluation, a focused visit can help you move from symptoms and uncertainty to a clear next step.

Your VidaVascular Care Team

Your evaluation and treatment are guided by our board-certified vascular and interventional radiologist and clinical team.

Dr. Meghal Antani, MD, FSIR, Medical Director of VidaVascular

Dr. Meghal Antani, MD, FSIR

Medical Director · Vascular & Interventional Radiologist

Ernest Bonsu, DMSc, MSc, PA-C, Physician Assistant at VidaVascular

Ernest Bonsu, DMSc, MSc, PA-C

Physician Assistant

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Where to Get PAD Care

Choose the office that is most convenient for you. All locations share one phone number for scheduling.

Frequently Asked Questions About PAD

VidaVascular has offices in Oxon Hill, MD, Springfield, VA, and White Plains, MD. Call (866) 800-2346 to schedule at the location most convenient for you.

VidaVascular accepts most major insurance providers. Coverage varies by plan and procedure, so please call us to confirm whether your specific plan is covered. Insurance information.

Yes. Clinicians can send referrals through our HIPAA-compliant clinician referral form, and patients or community members can use the patient/community referral form.

Call (866) 800-2346 or request an appointment online. Our offices are open Monday through Thursday, 8 AM to 5 PM, and Friday, 8 AM to 3 PM.

References

  1. Gornik, H. L., Aronow, H. D., Goodney, P. P., Arya, S., Packard Brewster, L., Byrd, L., Chandra, V., Drachman, D. E., Eaves, J. M., Ehrman, J. K., Evans, J. N., Getchius, T. S. D., Gutiérrez, J. A., Hawkins, B. M., Hess, C. N., Ho, K. J., Jones, W. S., Kim, E. S. H., Kinlay, S., et al. (2024). 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease. Circulation, 149(24), e1313–e1410. https://doi.org/10.1161/CIR.0000000000001251
  2. Gerhard Herman, M. D., Gornik, H. L., Barrett, C., Barshes, N. R., Corriere, M. A., Drachman, D. E., Fleisher, L. A., Fowkes, F. G. R., Hamburg, N. M., Kinlay, S., Lookstein, R., Misra, S., Mureebe, L., Olin, J. W., Patel, R. A., Regensteiner, J. G., Schanzer, A., Shishehbor, M. H., Stewart, K. J., et al. (2017). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation, 135, e726–e779. https://doi.org/10.1161/CIR.0000000000000470
  3. Xu, D., Zou, L., Xing, Y., Hou, L., Wei, Y., Zhang, J., Qiao, Y., Hu, D., Xu, Y., Li, J., & Ma, Y. (2013). Diagnostic value of ankle brachial index in peripheral arterial disease: A meta analysis. Canadian Journal of Cardiology, 29(4), 492–498. https://doi.org/10.1016/j.cjca.2012.06.014
  4. Nicolaï, S. P. A., Teijink, J. A. W., Prins, M. H., & EXITPAD Study Group. (2010). Multicenter randomized clinical trial of supervised exercise therapy with or without feedback versus walking advice for intermittent claudication. Journal of Vascular Surgery, 52(2), 348–355. https://doi.org/10.1016/j.jvs.2010.02.022
  5. Fakhry, F., Spronk, S., van der Laan, L., Wever, J. J., Teijink, J. A. W., Hoffmann, W. H., Smits, T. M., van Brussel, J. P., Stultiens, G. N. M., Derom, A., Hoed, T., Ho, G. H., van Dijk, L. C., Verhofstad, N., Orsini, M., Petersen, A., Woltman, K., Hulst, I., van Sambeek, M., et al. (2015). Endovascular revascularization and supervised exercise for peripheral artery disease and intermittent claudication: A randomized clinical trial. JAMA, 314(18), 1936–1944. https://doi.org/10.1001/jama.2015.14851
  6. Eikelboom, J. W., Connolly, S. J., Bosch, J., Dagenais, G. R., Hart, R. G., Shestakovska, O., Diaz, R., Alings, M., Lonn, E. M., Anand, S. S., Widimsky, P., Hori, M., Avezum, A., Piegas, L. S., Branch, K. R. H., Probstfield, J., Bhatt, D. L., Zhu, J., Liang, Y., et al. (2017). Rivaroxaban with or without aspirin in stable cardiovascular disease. The New England Journal of Medicine, 377(14), 1319–1330. https://doi.org/10.1056/NEJMoa1709118
  7. Bonaca, M. P., Bauersachs, R. M., Anand, S. S., Debus, E. S., Nehler, M. R., Patel, M. R., Fanelli, F., Capell, W. H., Diao, L., Jaeger, N., Hess, C. N., Hiatt, W. R., & VOYAGER PAD Investigators. (2020). Rivaroxaban in peripheral artery disease after revascularization. The New England Journal of Medicine, 382(21), 1994–2004. https://doi.org/10.1056/NEJMoa2000052

Ready to Learn More About PAD?

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