Peripheral artery disease (PAD)

Peripheral artery disease (PAD) is a condition that results when arteries narrow and limit blood flow to limbs, most often the legs. The disease typically develops due to atherosclerosis, which is a buildup of plaque in the arteries. PAD can cause circulatory issues, which can become serious without intervention.

PAD is the most common condition treated by vascular surgeons, both at Northwell and across the country. While we believe in taking a minimally invasive first approach, we take an aggressive approach to saving limbs and restoring function. That’s why each and every one of our vascular surgeons are trained extensively on all methods of treating PAD, ranging from the medical management of risk factors, to minimally invasive procedures and traditional surgical procedures. We’re committed to using this versatility to tailor a treatment plan to your particular situation. Our doctors are involved in groundbreaking research studies, which gives us early access to new technologies that might not yet be available in other institutions. You can always count on your care to be on the cutting edge and customized to you.

PAD most commonly affects the legs, where symptoms include pain and cramping while walking, a condition called claudication. Other symptoms include weakness, non-healing wounds on the feet and in extreme cases, gangrene.

If you experience any of these symptoms, it’s important to see a vascular doctor to determine if PAD could be the cause. We stress this even more if you are over the age of 65, or have numerous risk factors pertaining to the condition.  

Approximately 90 percent of PAD cases are caused by atherosclerosis, a buildup of plaque and other substances in the artery walls. This buildup causes arteries to narrow, which over time can lead to the development of PAD.

Aside from atherosclerosis, PAD is also related to coronary artery disease (CAD). The presence of PAD could be indicative of similar problems being present in other parts of the body, such as the heart. Like PAD, CAD is caused by atherosclerosis, specifically in the heart’s arteries. If left untreated, it could lead to a heart attack. 

You are at risk for PAD if you smoke, have diabetes, high blood pressure, high cholesterol or kidney failure. Your risk for the disease also increases with age. It's more prevalent in patients over the age of 65. However, those with multiple risk factors may develop the disease even earlier.

PAD can lead to serious complications without the right care. One of these is critical limb ischemia (CLI), a condition which occurs when wounds on the feet are unable to heal. This can lead to limb-threatening situations such as gangrene.

Many symptoms caused by PAD are manageable solely with the right lifestyle modifications. We might recommend that you quit smoking, exercise often, have a healthy diet and manage other risk factors like diabetes and high cholesterol in order to improve your quality of life.

Other times, a surgical procedure and/or medication may be a better option. Those medications are often prescribed to treat risk factors contributing to the disease. For instance, a statin might be prescribed if you have high cholesterol. Other medications might address the symptoms affecting your quality of life, such as medications that can improve your ability to walk further distances.

The recovery process ultimately depends on the treatment option that is most viable for your situation. If your treatment plan calls for a minimally invasive procedure, you can return to your normal life relatively quickly. For traditional surgical procedures, you might need to spend anywhere from three to seven days in the hospital.

PAD is a lifelong condition for which there is not a cure. For this reason, we follow up with you regularly to ensure the disease does not lead to complications, the most serious of which can cause the loss of limbs and even your life. Therefore, while many of the symptoms from the disease itself may not seem consequential, it is critical to give your care the attention it deserves and develop a strong relationship with your vascular surgeon.

Diagnosing PAD early, or even recognizing its likelihood for development, is one of the most effective preventative measures you can take. It allows us to optimize your care, and in the best-case scenario, prevent the disease altogether. That’s why we always recommend requesting a consultation with a vascular surgeon from the onset of circulatory symptoms. Other preventative measures include the management of risk factors. You should quit smoking immediately, as well as take steps to control your blood sugar, lower your cholesterol and lead a healthy and active lifestyle.