Peripheral Arterial Disease (PAD) is a condition similar to coronary artery disease and carotid artery
disease. (Coronary artery disease is the name for fatty buildups in the arteries that supply the heart
muscle with blood and nourishment. Carotid artery disease is the name for fatty buildups in the neck
artery that brings blood to the brain.) PAD is the preferred clinical term that should be used to denote
stenotic, occlusive and aneurysmal diseases of the aorta and its branch arteries, exclusive of the
coronary arteries. In PAD, fatty deposits build up in the inner lining of artery walls in the non-coronary
arteries to any other vital organ. These blockages thus are equally important as they restrict blood
circulation to the kidneys, intestines, arms, legs and feet. People with PAD often also have fatty
buildups in the arteries of the heart and brain, but aortic or lower extremity PAD may be their first sign
and provide a unique warning of vascular danger. Most people with PAD have a markedly increased
short-term risk of death from stroke and heart attack. If a blood clot forms and blocks a narrowed artery to
the heart, a heart attack results. If the clot blocks an artery to the brain, a stroke results. When leg artery
blockages are severe, pain, gangrene and limb loss may result.

Is peripheral arterial disease dangerous?
Yes. Any artery narrowing in any part of the body is associated with a nearly equal risk of heart attack,
stroke, or death. Yet, peripheral arterial disease also places other vital organs at risk. Inasmuch as PAD
defines the narrowing of arteries that carry blood to the legs, arms, stomach or kidneys, each of these
critical organs can be damaged. Often, the disease progresses silently for years until the damage
becomes evident.

 duplex ultrasound
 magnetic resonance angiogram
 CT angiogram
 regular (catheter-based) angiogram

Every individual with PAD should promptly lower their risk by taking action to:

 stop smoking (smokers are 2 to 25 times more likely to get PAD and all PAD-related
outcomes occur earlier, are more severe, and are less likely to be effectively treated in those
who continue to smoke)

 control diabetes
 control blood pressure
 eat a low-saturated-fat, low-cholesterol diet and control cholesterol levels
 be physically active (including use of a supervised exercise program)
 use an antiplatelet (clot preventing) medication

PAD may require treatment and the exact treatment will depend on the site and severity of the artery
blockages. For individuals with lower extremity PAD, effective treatments include:

 medicines to help improve walking distance
 supervised exercise programs
 angioplasty
 vascular surgical bypass

For most individuals with lower extremity PAD, lifestyle modifications alone (including an exercise
program) can usually both lower heart attack and stroke risk, and simultaneously improve symptoms, or
keep them from getting worse. In a minority of patients, lifestyle changes alone are not sufficient. Then
angioplasty or surgery may be needed. Angioplasty is a non-surgical procedure that widens narrowed
or blocked arteries. A thin tube, called a catheter, with a deflated balloon on its tip is passed into the
narrowed artery segment. Then the balloon is inflated. This pushes open the narrowed segment. Then
the balloon is deflated and the catheter is withdrawn.

Often a stent— a wire mesh tube— is placed in the narrowed artery with a catheter. There the stent
expands and locks open. It stays in that spot, keeping the diseased artery open.

If a long part of an artery is narrowed, vascular surgery may be needed. A vein from another part of
the body or a synthetic blood vessel is attached above and below the blocked area to detour blood
around the blocked spot.