Home > Heart Smart > Problems Outside of Your Heart
Problems Outside Your Heart:
Peripheral Artery Disease
Description
What is peripheral artery disease?
Peripheral artery disease (PAD) is a disease of the blood vessels in areas outside your heart. Also called peripheral vascular disease (PVD), this serious circulation problem affects arteries that carry blood to your arms and legs. Learn more.
Causes and Risk Factors
What are the causes and risk factors of peripheral artery disease?
More than 4 million Americans suffer leg pain symptoms. Those at the highest risk of PAD are over the age of 50, with high blood pressure, high cholesterol, diabetes and stroke. Learn more.
Symptoms
What are the symptoms of peripheral artery disease?
PAD may cause a dull, cramping pain in the legs, hips or buttocks when you exercise, that stops when you rest. This is a classic PAD symptom called claudication. Learn more.
Diagnosis
How is peripheral artery disease diagnosed?
The most common test for PAD is the ankle brachial index (ABI), a painless exam the uses ultrasound images to measure blood pressure in the feet and arms. Learn more.
Treatment
How is peripheral artery disease treated?
Doctors may prescribe medications, life-style changes, and procedures like angioplasty and stenting to open blocked vessels. Learn more.
What is it like to live with a stent placed for peripheral artery disease?
Patients with PAD can live full and active lives. Learn more.
Description
Do you have leg pain or trouble walking? Sometimes these problems are thought of as part of getting older. However, such problems may be signs of a serious circulation problem called peripheral artery disease, or PAD.
PAD is a disease of the blood vessels in areas outside the heart. Often, PAD affects the arteries that carry blood to the legs and arms. PAD is also called peripheral vascular disease, or PVD.
- The aorta, your body's largest artery, is attached directly to the left ventricle of your heart. The left ventricle pumps blood out of your heart through the aortic valve into the aorta. All other major arteries branch from the aorta and carry blood to the rest of your body.
- The carotid arteries are the main arteries in your head and neck that supply blood to your brain.
- The subclavian arteries supply blood to your arms.
- The renal arteries supply blood to your kidneys.
- The iliac arteries supply blood to your lower abdomen.
- At the pelvis, the iliac arteries become the femoral arteries, which supply blood to most of your legs.
- At your knees, the femoral arteries become the popliteal arteries, which supply blood to your lower legs.
- At your ankles, the popliteal arteries split into tibial arteries, which supply blood to your feet.
Did you know?
- 8 to 12 million people in the United States have PAD
- 12% to 20% (4.5 to 7.6 million) of those who have PAD are over 65 years of age.
- By 2050, a projected 19 million people will have PAD.
- Patients who suffer from either peripheral or coronary artery disease appear to be at a higher risk for the development of both conditions. 1
Causes and Risk Factors
Like atherosclerosis, PAD occurs when the arteries become narrowed by a buildup of plaque — including cholesterol, fatty deposits, calcium, and other substances in the blood. Blocked arteries can prevent oxygen-rich blood from reaching the muscles when the muscles need it most. This lack of oxygen causes pain. PAD can increase your risk of heart attack and stroke. But the good news is that PAD can be easy to diagnose and is treatable.
PAD is generally also affected by the following risk factors. The more risk factors you have, the greater your chances of developing an artery blockage.
- Eating high-fat foods
- Lack of exercise
- Smoking
- Stress
- Excess weight
There are also some risk factors that cannot be avoided, such as menopause, aging, or having a family history of heart disease. Additionally, men are also at higher risk of PAD than women.
People with PAD can have a six- to seven-times higher risk of heart attack and stroke. About one third of patients with PAD who have a heart attack or stroke die from it. Also, if PAD is not treated, the symptoms can get worse. It may become very difficult and painful to get around. Severe PAD may even cause serious infections that can result in the loss of a limb. If you think you may be at risk, ask your doctor whether you should be screened.
If you have symptoms or think you may be at risk, get screened for PAD. You can get screened at your doctor's office. The tests for PAD can be quick and painless — as simple as a blood pressure measurement.
Questions to Ask Your Health Care Provider
If you believe you are at risk for PAD, discuss this concern with your health care provider. Find out if you should be tested for PAD and what you can do to lower your risk.
- Does my medical history raise my risk for PAD?
- Which screening tests or exams are right for me?
- If I have PAD, what steps should I take to treat it?
- Will PAD increase my risk for other conditions?
- What is my blood sugar level? If it's too high or if I have diabetes, what should I do about it?
- What is my blood pressure? Do I need to do anything to manage these numbers?
- What are my cholesterol numbers? (These include total cholesterol, LDL, HDL, and triglycerides-a type of fat found in the blood and food.) Do I need to do anything about them?
- What can I do to quit smoking?
Symptoms
One of the classic symptoms of PAD is dull, cramping pain in the legs, hips, or buttocks that happens when you exercise. This pain stops when you rest — a symptom called intermittent claudication. Some people with PAD have pain even when they are not exercising.
Other symptoms of PAD include:
- Numbness or tingling in the legs, feet, or toes
- Changes in skin color (pale, bluish, or reddish coloration)
- Cool skin (for example, in the legs, feet, arms, or hands)
- Impotence
- Infections/sores that do not heal
Symptoms usually appear in the part of the body that has blocked arteries. But people with PAD can also be symptom-free. So it is important to be aware of your risk. View our PAD risk checklist.
Diagnosis
How is peripheral artery disease diagnosed?
The most common test for PAD is the ankle-brachial index (ABI). The ABI compares the blood pressure in your legs and arms (brachial means "of the arm") using a blood pressure cuff. If the pressures are different, it could mean you have PAD.
If the ABI shows that you may have PAD, your doctor may do other tests. The following tests can help show the location of the blocked artery and how serious the blockage is.
- Duplex Doppler ultrasound — This test uses sound waves to create a picture of the arteries. This type of ultrasound can also show if blood is flowing smoothly through the arteries.
- Magnetic resonance imaging (MRI) — Radio waves in a magnetic field are used to create flat or three-dimensional pictures of the arteries. If you have a pacemaker or implantable cardioverter defibrillator (ICD), be sure to check with your doctor before having an MRI.
- Angiography — For this test, you are given a local anesthetic. Then, a special dye is injected into the artery through a small tube called a catheter. The dye shows up on x-rays and helps determine which arteries are narrowed or blocked.
- Computerized tomography angiography (CTA) — For CTA, the dye is injected into a blood vessel, and x-rays are taken from different angles. Then, a computer analyzes the x-rays to form a three- dimensional picture of the arteries.
Free Screenings Are Available
The Boston Scientific Foundation is proud to support Legs for Life — National Screening Program for PAD Leg Pain. This program, founded by the Society of Interventional Radiology in 1997, is dedicated to identifying patients at high risk for PAD. About a quarter of a million people have been screened so far. One in four was found to be at risk for PAD.
Free screenings will be available in hundreds of hospitals, clinics, and senior centers across the country in September. For more information about PAD and Legs for Life screening sites, visit
Treatment
How is peripheral artery disease treated?
Treatment for PAD depends on how severe the disease is. So, it can be a great advantage to find PAD early. The solution is often simple. For example, your doctor may recommend exercise or medications. Exercise can cause new, tiny blood vessels to grow and bring oxygen to problem areas. Your doctor can prescribe medicines to reduce pain or prevent blood clots. Also, medicines may be needed to control diabetes, high blood pressure, or high cholesterol because these conditions, if not treated, can increase the risk for PAD.
Your doctor may decide it is necessary to treat the blocked arteries. One or more of these procedures could be used to help blood flow freely again through the affected arteries:
- Angioplasty — a catheter with a balloon is passed through the blocked artery. Once inflated, the balloon compresses the plaque against the wall of the artery.
- Stent implantation — during angioplasty, a tiny metal mesh tube called a stent may be placed in the artery to help hold it open.
- Atherectomy — a special catheter is used to gently shave and remove plaque from the arteries.
- Endarterectomy — a special catheter is used to open blocked blood vessels by removing plaque buildup from inside the artery wall.
- Bypass surgery — a healthy blood vessel taken from another part of the body, or a small man-made tube, is used to create a detour to allow blood to flow around a blocked artery.
Success Stories
What is it like to live with a stent placed for peripheral artery disease? 
Sharon Knapp tells her story about living with peripheral artery disease. Learn more.
Print This Page
