Nearly 12 million Americans have peripheral arterial disease or PAD, a vascular arterial disease that causes blockages in the arteries to the legs due to the buildup of plaque. Peripheral arterial disease is different than heart disease because the blockages are outside the heart, specifically in the arteries of the abdomen, pelvis and legs.
Patients with peripheral arterial disease may also hear the terms peripheral vascular disease (PVD) or peripheral vascular occlusive disease (PVOD). These terms are more generalized, also encompassing arteries outside the heart but including those in the neck and kidneys as well as the legs.
In some PAD patients, the vascular system may compensate for the reduced blood flow by forming alternative routes, called collateral vessels, which bypass the affected vasculature. In others, collateral vessels may not be sufficient, resulting in foot pain at rest and non-healing sores on the feet.
Over time, smoking, poor diet and inactivity, in conjunction with diseases such as hypertension and diabetes, cause the vein walls to become rigid and narrow.
Common PAD symptoms include:
- Persistent or intermittent leg pain (claudication) or cramping when walking
- Numbness or loss of sensation in the affected limb
- Sores that heal slowly or fail to heal
- Differences between limbs in relation to color and/or warmth
- Decreased rate of hair and nail growth on the impacted limb
- Foot pain at rest
While peripheral arterial disease is not life threatening, it can affect quality of life, and can be a red-flag warning of more serious conditions, including heart disease. If not properly managed, PAD can lead to heart attack or stroke. To learn more, go to our Frequently Asked Questions About PAD page.
Diagnosis of PAD
If PAD is suspected, your health care provider will perform a non-invasive test known as an ankle brachial pressure index (ABI). The ABI measures the difference between the systolic blood pressure in your arms and the systolic pressure in your ankles. Based on the result of this test, an ultrasound may be ordered to determine the extent of the blockage. Angiography, an X-ray dye procedure, or a Computed Tomography Angiography (CTA) scan may also be used to more precisely define the exact location of the blockage if a procedure is indicated.
Depending on the severity of your peripheral arterial disease, the U-M Frankel Cardiovascular Center vascular surgery team offers various treatments. PAD treatments focus primarily on lowering your risk factors combined with medical (non-surgical) therapies. If PAD reduces blood flow to such an extent that walking is affected, you experience pain at rest or a wound or sore doesn't heal properly, you may need intervention or surgery.
Because PAD most commonly results from atherosclerosis or hardening of the arteries, you can reduce your risk by following these guidelines:
- Don't smoke.
- If you have diabetes, see your health care provider regularly and follow all diet and medication instructions.
- Lower your blood pressure if it is high.
- Eat foods low in fat and cholesterol.
- Lose weight if you are overweight.
- Exercise regularly according to your health care provider's recommendations.
- Reduce stress in your life.
PAD Treatment at the University of Michigan
The University of Michigan's vascular surgeons are national leaders in research, open surgery and endovascular procedures for PAD. We will work with you to create an individualized care plan that may include medical management, open or endovascular surgery. In addition to creating a treatment plan tailored to each patient, we also offer programs in smoking cessation, dietary counseling, wound care and prosthetics.
Any patient with peripheral arterial disease can be seen in the clinic, from mild cases to limb-threatening, disabling conditions. Our physicians will work to help save your leg. Patients who have already been diagnosed with PAD, claudication, an abnormal ABI test result and/or non-healing ulcers due to arterial insufficiency are seen within 48 hours after we have been contacted by a referring physician. We are able to handle emergent cases at any time.
PAD-Related Clinical Research
In addition to these surgical and non-surgical treatment options, the University of Michigan also has opportunities for patients to participate in clinical research studies. Learn more about these PAD-related clinical research studies(link is external).
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