Peripheral Artery Disease

Peripheral Artery Disease (PAD) is a condition in which cholesterol and plaque build up inside the arteries, reducing blood flow to the legs and feet. Left untreated, PAD can lead to chronic leg pain, non-healing wounds, infection, gangrene, and even limb amputation. It also increases your risk of heart attack and stroke.

The most common symptom of PAD is claudication—cramping, aching, or fatigue in the legs that occurs while walking and improves with rest.

Other symptoms may include:

• Leg pain at rest (advanced disease)
• Non-healing wounds or ulcers
• Changes in skin color
• Hair loss on the legs
• Poor circulation

PAD is most commonly caused by atherosclerosis, or hardening of the arteries. Risk factors include:

• Smoking
• Diabetes
• High cholesterol
• High blood pressure
• Kidney disease
• Family history of vascular disease
• Increasing age

Managing these risk factors can help slow the progression of PAD.

Our physicians perform a comprehensive vascular evaluation that may include:

• Ankle-Brachial Index (ABI)
• Toe-Brachial Index (TBI)
• Arterial Duplex Ultrasound
• CT Angiography (CTA)
• MR Angiography (MRA)
• Diagnostic Angiography

Our IAC-accredited vascular laboratory allows many patients to complete some of their testing in our office.

Yes. An angiogram is considered the gold standard for diagnosing Peripheral Artery Disease because it provides the most accurate and detailed visualization of the arteries. It allows your physician to identify exactly where blockages are located, how severe they are, and whether they can be treated during the same procedure.

Although many patients begin with non-invasive tests such as ABI, TBI, or arterial ultrasound, an angiogram is often recommended when intervention is being considered or when additional information is needed to guide treatment.

Treatment depends on the severity of your disease and may include lifestyle modifications, medication, or minimally invasive procedures.

Endovascular treatment options include:

• Balloon Angioplasty – Opens narrowed arteries using a small balloon.
• Stent Placement – A tiny metal mesh tube helps keep the artery open.
• Atherectomy – Specialized devices remove/treat plaque and calcium from inside the artery.

Many of these procedures are performed through a tiny puncture, require no large incision, and allow patients to return home the same day. Open bypass surgery is reserved for selected patients with more advanced disease.

Yes. Lifestyle changes are one of the most important parts of treating PAD and preventing disease progression.

Your physician may recommend:

• Quitting smoking
• A supervised walking program
• Heart-healthy diet
• Cholesterol management
• Blood pressure control
• Diabetes management
• Regular exercise, when appropriate

An angiogram is a minimally invasive imaging procedure that allows your physician to see the arteries in real time and identify areas of narrowing or blockage.

A tiny catheter is inserted through a small puncture in the wrist or groin, and contrast dye is injected while X-ray images are obtained. If appropriate, treatment can often be performed during the same procedure.

Most angiograms take 60–90 minutes, and patients receive local anesthesia with medication to help them relax.

Before your procedure, you may be asked to:

• Stop eating after midnight
• Continue most medications unless instructed otherwise
• Discuss blood thinners with your physician
• Inform us of any contrast dye allergies
• Arrange for someone to drive you home

After your angiogram, most patients:

• Return home the same day
• Drink plenty of fluids
• Avoid strenuous activity and heavy lifting for approximately 48 hours

Angiography is considered a very safe procedure, and your physician will review any potential risks with you before treatment.

Most patients are discharged 1–4 hours after their procedure. Recovery time may vary depending on the complexity of the procedure and whether an intervention such as angioplasty, atherectomy, or stent placement was performed. Before you leave, our team will monitor your recovery, review your medications and activity restrictions, and provide detailed post-procedure instructions. Because sedation is used, you will need a responsible adult to drive you home.

Yes. PAD angiograms and minimally invasive endovascular procedures have an excellent safety record and are routinely performed by experienced Interventional Radiologists.

Major complications occur in less than 1% of patients, making these procedures significantly less invasive than traditional open vascular surgery. Most patients are treated through a tiny puncture in the wrist or groin, without the need for large incisions, and return home the same day.

A previous contrast allergy does not necessarily prevent you from having an angiogram. Many patients can safely undergo the procedure after taking medications beforehand to reduce the risk of a reaction. Be sure to tell your physician about any previous reactions to contrast dye so we can develop the safest treatment plan for you. Shellfish allergies alone are not considered a contraindication to receiving iodinated contrast.

No. PAD affects the arteries. Varicose veins may be a sign of underlying vein disease. Although they are different conditions, many patients have both. Treating both arterial and venous disease can improve circulation, relieve symptoms, and promote wound healing.

Yes. Most diagnostic testing, angiography, and medically necessary PAD treatments are covered by Medicare and most commercial insurance plans. Our office will verify your insurance benefits and obtain any necessary prior authorizations before your procedure.

You should schedule an evaluation if you experience:

• Leg pain or cramping while walking
• Pain in your feet or legs while resting
• Non-healing wounds or ulcers
• Poor circulation
• Changes in skin color

Early diagnosis and treatment can improve your circulation, reduce your symptoms, and help prevent serious complications, including limb loss.