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Home | Treatments | Peripheral Artery Disease – PAD Treatment
What is Peripheral Artery Disease?
PAD is a condition where the arteries in your legs don’t receive enough blood. This can mean essential oxygen and nutrients don’t reach the legs and feet, causing discomfort. PAD typically starts in a single leg but can affect both legs.
Symptoms and Risk Factors
PAD most commonly causes leg pain and other symptoms, although almost 4 in 10 people don’t experience any leg pain.
The most prominent symptom of PAD is intermittent claudication, or leg discomfort (aching, cramping, or pain) that increases while walking and decreases when sitting or lying down. For some people, foot pain may disrupt their sleep.
PAD may also cause difficulty healing. Wounds on the legs or feet may be slow to heal because of inadequate nutrients and oxygen, which can lead to ulcers (wounds that don’t heal). If you are experiencing these symptoms, visiting a peripheral artery disease clinic early can help prevent serious complications.
Non-healing wounds may eventually lead to tissue death, called gangrene. If untreated, gangrene can spread and require amputation of the foot or leg.
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PAD treatment includes a multi-faceted approach. Medications and lifestyle interventions may be able to treat and prevent the worsening of the blood vessels. Revascularization may sometimes be recommended to enhance blood flow and prevent tissue damage. At our peripheral artery disease treatment clinic, we offer a range of minimally invasive procedures. This may include angioplasty, a procedure that uses a tiny balloon to inflate and widen the blood vessel. A graft may also be used to bypass the artery and allow for better blood flow to the area. These minimally invasive procedures can be performed in our spa-like outpatient suite to ensure a comfortable, convenient experience.
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– Anthony P.
“I was referred to Dr. W. Julian by my PCP and very happy that I was. Dr. Julian found a clogged artery that could have been life threatening if left untreated. My experience from consult to discharge was met courtesy, warmth and professionalism which helped me through my procedure. Sean greeted me and my son who explained the whole process and what to expect. I was also looked after by Josh, Jackie and Reuben who could not have been more supportive or communicative through this adventure.”
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“I'd like to express my gratitude for taking care of me this past Monday for the venous procedure on my legs. Please extend my gratitude to the staff who took care of me, like Anissa Rodriguez, Josh Rush, Kerx, Maruli, Rosaline, and Daniela. You were all so very professional and kind.”
– Luis M.
“I recently visited South Florida Vascular Associates with my father, who had his Hemorrhoid Artery Embolization (HAE), and was very impressed with the quality of care and professionalism from start to finish. From the moment we walked in, the staff was welcoming and attentive, creating a calm and reassuring environment.”
Coronary stents are used during angioplasty procedures. A stent is a small, expandable metal mesh coil that is placed into a newly opened area of the artery to keep it from narrowing or closing.
During this procedure, a small incision is created in the groin to gain access to the artery. The physician will then thread a balloon-tipped catheter through the incision site and arterial system to the leg artery that is narrowed or blocked. Once the balloon is positioned under the plaque, it is inflated to break apart and compress the plaque and widen the blood vessel to improve blood flow. In certain cases, the physician may also insert a stent to keep the artery open following angioplasty.
Successful angioplasty procedures have great results. Approximately 60-70% of patients who undergo an angioplasty have patent vessels that remain open due to adequate blood flow to the legs for 2 years after the procedure.
The initial angioplasty failure rate for patients with leg artery disease is about 10%. Failure may occur when the catheter is unable to move through the blockage or a weakened artery collapses after angioplasty and cannot be kept open.
Not all artery diseases can be treated with angioplasty. For more advanced forms of peripheral artery disease or critical limb ischemia, more invasive procedures may be needed. Your provider will discuss the best way to treat your condition based on your circumstances.
What is Atherectomy?
Atherectomy is a minimally invasive procedure used to remove plaque buildup and open narrow or blocked arteries in those with peripheral artery disease (PAD).
During this procedure, your provider will utilize a catheter equipped with a sharp blade or laser to cut or scrape out the hard plaque. Atherectomy is one of the advanced options available at our clinic for PAD treatment, especially for complex cases.
Frequently Asked Questions
What is considered the first symptom of peripheral arterial disease?
The first symptom of peripheral arterial disease is often characterized by pain, cramping, or fatigue in the legs during physical activity such as walking or climbing stairs. This discomfort is typically due to narrowed arteries but subsides with rest.
What is the life expectancy of someone with peripheral arterial disease?
The life expectancy of someone with peripheral arterial disease can vary depending on various factors such as the severity of the disease, overall health, and lifestyle choices. Generally, the disease creates an increased risk of cardiovascular events.
How many stages are there in peripheral artery disease?
Peripheral arterial disease progresses through four stages-- these stages range from asymptomatic (Stage 1) to critical limb ischemia (Stage 4). Stage 1 involves no symptoms, while Stage 4 is characterized by severe pain at rest, ulcers, or gangrene.
What do legs look like with peripheral artery disease?
As the condition progresses, symptoms such as skin discoloration, coolness to the touch, hair loss on the legs, and slow-healing wounds or ulcers may develop. In severe cases, gangrene or tissue death can occur.
How should patients maintain peripheral artery disease?
Individuals with peripheral artery disease should avoid smoking and practice maintaining a healthy lifestyle with regular exercise, a balanced diet, and proper management of other health conditions like diabetes and high blood pressure.
Is coffee bad for peripheral artery disease?
While moderation is key, coffee consumption is generally considered safe for individuals with peripheral artery disease. Excessive caffeine intake can lead to increased heart rate and blood pressure, which may exacerbate symptoms of peripheral artery disease.
Who is most at risk of peripheral artery disease?
Older adults, smokers, people with diabetes, and those with high blood pressure are at risk of peripheral artery disease. Anyone with high cholesterol, obesity, or who has a family history of cardiovascular disease is also at higher risk of the disease.
What happens if PAD is left untreated?
If PAD is left untreated, it can lead to a variety of serious complications. PAD is related to a heart attack, stroke, and can lead to limb loss ( amputation), and even death.
How is PAD diagnosed?
PAD is typically diagnosed by first looking at your medical history. From there, we will check for a weak or absent pulse in the legs and feet and look for changes in the limbs, including deformities. We can also perform an ankle-brachial index (comparing the blood pressure in the arms and legs) and an ultrasound.
Is anesthesia needed for an angioplasty for PAD?
Yes, local anesthesia is typically used for an angioplasty. It will numb the area and ensure you’re relaxed while remaining awake.
What causes peripheral artery disease?
PAD is primarily caused by atherosclerosis, a condition where fatty deposits build up in the walls of the arteries. This reduces blood flow in the legs and can lead to PAD.
Are there any ways to prevent PAD?
Yes, there are many ways to prevent PAD. Quitting smoking, exercising regularly, eating a healthy diet, and avoiding saturated fats are just a few ways to help prevent PAD. Managing your cholesterol, diabetes, and blood pressure is also vital.
How common is PAD?
PAD is very common. Around 12 million adults over the age of 40 in the US struggle with the condition. Anyone can develop the condition, but the risk goes up as you age.
How common is peripheral artery disease?
Peripheral artery disease is a common condition. Between 8 to 20 million people in the United States struggle with PAD, and it affects about 1 in 5 people over the age of 70.
Are there ways to prevent peripheral artery disease?
Yes, there are several ways you can prevent peripheral artery disease. Sticking to a healthy lifestyle is the easiest way to prevent the condition. This includes eating a healthy diet, exercising regularly, and not smoking. Managing your blood pressure, cholesterol, and diabetes is also recommended.
Can PAD be life-threatening?
Yes, if left untreated, PAD can be life-threatening. It’s why seeking treatment as soon as possible is so important.
Are there lifestyle changes I can make to help manage PAD?
Absolutely! Quitting smoking, exercising regularly, and sticking to a heart-healthy diet can all help manage your PAD symptoms. Managing any other heart or health conditions, staying hydrated, and de-stressing can also help keep your PAD under control.
Are there any medications that can help with PAD?
Yes, there are several different medications that can help manage and treat PAD. Statins to lower cholesterol, antiplatelet medications like aspirin, high blood pressure medication, and drugs that improve blood flow can all be prescribed to help with PAD.
Is there a cure for PAD?
Unfortunately, there is no cure for PAD, but there are many ways to manage the condition so you can live a full and healthy life. With medications, lifestyle changes, angioplasty, and other procedures, you can slow the progression of the disease.
Why does leg pain from peripheral artery disease improve when I stop walking?
Walking increases the muscles’ demand for oxygen-rich blood. When narrowed arteries cannot supply enough blood, cramping, aching, heaviness, or fatigue may develop. This discomfort, called intermittent claudication, typically improves after several minutes of rest because the muscles’ oxygen needs decrease.
Can I have peripheral artery disease without experiencing leg pain?
Some people have no noticeable symptoms, while others experience numbness, weakness, cold feet, slow-growing toenails, or wounds that heal poorly. Symptoms may also be overlooked when limited mobility prevents a person from walking far enough to trigger discomfort.
Why is an ankle-brachial index test used to diagnose PAD?
An ankle-brachial index, or ABI, compares the blood pressure at the ankle with the blood pressure in the arm. A lower pressure in the ankle may indicate reduced blood flow to the legs. If resting results are inconclusive, the test may be repeated after treadmill exercise to identify circulation problems that appear during activity.
Is it safe to walk when PAD causes leg discomfort?
For many patients, a structured walking program is an important part of treatment. Walking until moderate discomfort develops, resting, and then walking again can gradually improve endurance and help the body use available blood flow more efficiently. A healthcare provider should determine the appropriate exercise level based on the severity of the condition.
Why does a diagnosis of PAD affect more than the legs?
PAD is usually caused by atherosclerosis, which can affect arteries throughout the body. Therefore, someone with PAD may also have an elevated risk of heart attack or stroke. Treatment often includes managing cholesterol, blood pressure, blood sugar, smoking, and other cardiovascular risk factors, not only addressing leg symptoms.
When does PAD require an angioplasty, stent, or bypass procedure?
A procedure may be considered when symptoms significantly interfere with daily activities despite medication and supervised exercise. Intervention may also be necessary when severely reduced circulation causes pain at rest, nonhealing wounds, tissue damage, or a threatened limb. The appropriate procedure depends on the location and extent of the arterial blockage.
What foot changes should someone with PAD report promptly?
Patients should contact their healthcare provider about sores that do not heal, skin discoloration, increasing redness, drainage, swelling, or new pain in the feet or toes. A suddenly cold, pale, numb, or severely painful limb requires immediate medical attention because it may indicate an abrupt loss of blood flow.
Dr. Julien has performed more than 40,000 vascular procedures across a 30-year career. Double board-certified in Interventional Radiology and Diagnostic Radiology by the American Board of Radiology, he is the co-founder and past president of the Outpatient Endovascular & Interventional Society, a national faculty speaker at SIR, TCT, VIVA, and the Southeastern Angiographic Society, and a published author. Named a Boca Magazine Top Doctor 2025.
To learn more about angioplasty, stenting, and atherectomy, please contact South Florida Vascular Associates by giving us a call or filling out our online form. We serve the greater Southeast Florida areas with locations in Coconut Creek, Palm Beach, and Plantation, FL.
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