Peripheral Arterial Disease: Causes, Symptoms and Treatment

Blood flow is an important process in the body that helps maintain many of our basic functions, but it’s also complex. Blood flows throughout the body, assisting different organs and tissues with their various functions, all while providing oxygen and other vital nutrients the body needs to survive.

Because the flow of blood is complicated, there are common problems that can occur. One of the most common of these problems is called peripheral arterial disease (PAD). PAD involves the narrowing of arteries, which means that certain parts of the body don’t get as much blood as they need. PAD often occurs in the legs and lower body – the area furthest away from the heart, and the area fighting gravity in the blood flow process.

Like many blood-related conditions, there are both genetic and lifestyle factors that contribute to PAD. While there are certain risk factors we might not be able to control, healthy, controllable lifestyle choices can help reduce your risk.

Causes and Risk Factors

The most common cause of peripheral arterial disease is another disease called atherosclerosis. Atherosclerosis involves the buildup and hardening of plaque in the arteries over time, making them narrower. When atherosclerosis occurs in the arteries that are supplying blood to your legs, it causes PAD. In some rarer cases, PAD can be caused by:

  • Injury to legs or other limbs
  • Radiation exposure
  • Abnormal anatomy of ligaments or muscles
  • Blood vessel inflammation

There are several risk factors that can also increase the likelihood of developing PAD:


Symptoms of peripheral artery disease include:

  • Claudication: This is the most common symptom, referring to cramping anywhere in the legs – from the hip to the thigh and calf muscles
  • Coldness, numbness or weakness in legs or feet
  • Sores on toes or feet
  • Changes in leg color, or shiny skin on the legs
  • Erectile dysfunction in some men
  • Weak or absent pulse in the legs or feet
  • Slow growth of hair and toenails

In severe cases, PAD caused by atherosclerosis can cause strokes, heart attacks and a condition called critical limb ischemia, a disease in which infections cause gangrene (death of tissue) and may even lead to amputation of the leg.


Diagnosing PAD can involve a few different tests:

  • Physical exam: Physical exams check for signs like weak pulse, lack of healing in a wounded area, decreased blood pressure or whooshing sounds in the arteries that might signal some of these other conditions (these sounds can be heard with a stethoscope).
  • Ultrasound: Using sound waves, ultrasound imaging detects blood flow and locates narrow arteries.
  • Ankle-brachial index: Abbreviated ABI, this is a common test that takes a blood pressure reading from both your ankle and your arm, then compares them side-by-side. This can identify areas that are struggling with blood flow.
  • Angiography: This is a process of injecting dye into the blood vessels, then using imaging techniques like X-ray, CT scan or an alternative form of MRI (magnetic resonance angiography, or MRA) to track the dye and detect abnormalities. Angiography can also be done using a catheter through the groin.
  • Blood tests: These check cholesterol levels and look for symptoms of diabetes.

Treatment and Prevention

You can help prevent PAD by making healthy choices, and doctors encourage many of these choices as good preventive measures. To prevent PAD:

  • Quit smoking: Smoking is one of the largest lifestyle choices contributing to PAD.
  • Eat a healthy diet: Eating well can control blood pressure and cholesterol, two of the biggest factors in atherosclerosis.
  • Exercise often: Doctors often measure recovery by checking how far you can walk without noticeable pain.

For those who do develop PAD, treatment options include:

  • Medication: There are several medications that might be used for PAD, ranging from cholesterol and blood pressure assists to medicines for blood sugar, blood clots and pain relief. Your doctor will decide which of these you might need.
  • Angioplasty: During this procedure, your doctor will feed a catheter up to the blood vessel, inflating a balloon at the end of the catheter, which helps widen the artery. In some cases, your doctor will also insert a mesh object (called a stent) to keep the artery open.
  • Surgery: Either bypass surgery (to create a new vessel or pull one from another place in the body, and divert blood around the damaged artery) or thrombolytic surgery (injection of a clot-dissolving drug to break up a clot) are used.

If you think you might be displaying some of the symptoms of peripheral arterial disease or atherosclerosis, speak to your doctor about your options.


“Peripheral artery disease (PAD).” The Mayo Clinic.

“About Peripheral Artery Disease (PAD).” American Heart Association.


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