Lower Extremity Arterial Disease

What is PAD?

Lower Extremity Arterial Disease (also Peripheral Artery Disease - PAD) is where plaque builds up and can occur anywhere in the body including the arteries supplying the legs. When significant blockage occurs in these arteries, there is decreased blood flow to the muscles of the legs and feet resulting in symptoms.

Less frequently, a clot (from the heart or elsewhere) can cause sudden loss of blood flow to the leg resulting in an emergency that threatens potential limb loss – immediate restoration of blood flow is essential.

What are the Signs/Symptoms of PAD?

Signs and symptoms of lower extremity artery disease may include leg:

• Leg pain, cramping, tightness, fatigue – often worse with walking/exertion and relieved by rest

• Leg weakness, numbness

• Cool and/or pale feet

• Weak or absent pulses in the legs/feet

• Decreased hair, nail growth

• Foot wound/ulcer that is slow to heal or not healing

• Rest pain of the foot/leg, especially when sudden, is concerning for acute limb ischemia

How is PAD Diagnosed?

Testing for lower extremity artery disease may include:

• Ankle-Brachial Index (ABI)Lower extremity artery ultrasound

• CT and/or MR angiography

• Angiography

What are the Treatment Options for PAD?

Treatment for lower extremity peripheral artery disease includes smoking cessation (when appropriate), additional risk factor modification to reduce likelihood of more plaque build up (similar to management for coronary artery disease), exercise, medication, and when necessary to restore blood flow, catheter-based treatments (thrombectomy, thrombolysis, atherectomy, angioplasty, stenting) or bypass surgery.