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Medically Reviewed By:

2026-05-01

  • Condition
  • Arterial
  • Severity: Urgent

Peripheral Artery Disease (PAD)

Also Known As: PAD
Peripheral artery disease (PAD) is a narrowing or blockage of the arteries supplying the legs and feet, caused by atherosclerosis — the buildup of fatty plaque within the artery walls. PAD affects approximately 8–10 million Americans and is a leading cause of leg pain, reduced walking ability, and limb-threatening wounds. PAD is also a major indicator of systemic cardiovascular disease, significantly elevating the risk of heart attack and stroke.


Who Gets PAD?

PAD disproportionately affects older adults, smokers, diabetics, and patients with high blood pressure or high cholesterol. Prevalence rises sharply with age — affecting approximately 12–20% of adults over 65. Florida’s large retirement population means PAD is a common and important condition throughout Sarasota and Manatee counties. Early detection and treatment save limbs and lives.


PAD Symptoms

The hallmark symptom of PAD is claudication — a reproducible cramping, aching, or fatigue in the calf, thigh, or buttock that comes on with walking a predictable distance and relieves within minutes of rest. As disease progresses, rest pain develops — a burning, aching sensation in the foot that is worst at night and when lying down. The most severe stage is critical limb ischemia, characterized by non-healing wounds or gangrene.


Diagnosing PAD in Sarasota & Bradenton

The ankle-brachial index (ABI) is the primary non-invasive test for PAD — comparing blood pressure at the ankle with the arm. An ABI below 0.9 is diagnostic of PAD. Duplex arterial ultrasound maps the location and severity of stenoses. CT angiography provides detailed anatomical roadmapping for intervention planning.


PAD Treatment Options

Management includes aggressive cardiovascular risk factor modification — smoking cessation, statin therapy, blood pressure and diabetes control, and antiplatelet therapy — combined with supervised exercise therapy, which is proven to improve walking distance significantly. When symptoms are severe or limb-threatening, revascularization is required.

Lower Extremity Bypass

Surgical bypass grafting — using the patient’s own vein or a synthetic conduit to route blood around the blocked segment — remains the gold standard for complex, long-segment occlusions involving the femoral-popliteal or tibial vessels. Lower extremity bypass provides durable long-term patency and is particularly effective for limb salvage in patients with critical limb ischemia.


Endovascular Treatment

Catheter-based angioplasty and stenting can open blocked or narrowed arteries with minimal incisions and a fast recovery. Endovascular treatment is preferred for shorter, focal lesions and high-risk surgical patients.

SYMPTOMS

  • Leg pain or cramping with walking (claudication) that improves with rest
  • Cold or pale feet and lower legs
  • Non-healing wounds on the feet or toes
  • Rest pain in the foot or toes at night (severe disease)
  • Hair loss on the lower leg and foot
  • Diminished or absent pulses in the foot

DIAGNOSIS METHODS

  • Ankle-Brachial Index (ABI) +

    Non-invasive blood pressure test comparing ankle and arm pressure — the primary screening test for PAD.

  • Duplex Arterial Ultrasound +

    Maps arterial blockages in the leg arteries without radiation.

  • CT Angiography +

    Provides detailed arterial anatomy for planning bypass or endovascular intervention.

  • MRI Angiography +

    Non-contrast alternative preferred in patients with kidney disease.

TREATMENTS

RELATED CONDITIONS

FREQUENTLY ASKED QUESTIONS

  • Is PAD the same as poor circulation? +

    'Poor circulation' is a colloquial term that often refers to PAD. PAD is the specific, diagnosable medical condition of arterial blockage in the lower extremities — and it is a serious disease that substantially increases heart attack and stroke risk, not just a benign nuisance.

  • Can walking really improve PAD? +

    Yes. Supervised exercise therapy is one of the most effective PAD treatments available. Walking to near-claudication pain daily stimulates the development of collateral vessels and significantly increases the distance patients can walk without symptoms — often matching the benefit of angioplasty in mild-to-moderate PAD.

  • Will I lose my leg if I have PAD? +

    The majority of PAD patients never progress to limb loss. With appropriate medical management and, when needed, timely revascularization, most patients maintain their limbs and quality of life. Smoking cessation is the single most important modifiable factor in slowing PAD progression.

  • Is PAD related to heart disease? +

    Yes — strongly. PAD and coronary artery disease share the same underlying process (atherosclerosis) and the same risk factors. Patients with PAD have a two- to four-fold increased risk of heart attack and stroke compared with people without PAD. PAD is now considered a cardiovascular risk equivalent to having had a heart attack.