Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD) is plaque buildup in your leg arteries. Your leg arteries carry oxygen and nutrient-rich blood from your heart to your arms and legs. Other names for this are peripheral vascular disease or peripheral arterial disease.

Shaped like hollow tubes, arteries have a smooth lining that prevents blood from clotting and promotes steady blood flow. When you have peripheral artery disease, plaque (made of fat, cholesterol and other substances) forms gradually inside your artery walls. Slowly, this narrows your arteries. This is also known as atherosclerosis.

Many plaque deposits are hard on the outside and soft on the inside. The hard surface can crack or tear, allowing platelets (disc-shaped particles in your blood that help it clot) to come to the area. Blood clots can form around the plaque, making your artery even narrower.

If plaque or a blood clot narrows or blocks your arteries, blood can’t get through to nourish organs and other tissues. This causes damage ― and eventually death (gangrene) ― to the tissues below the blockage. This happens most often in your toes and feet.

PAD can get worse faster in some people more than others. Many other factors matter, including where in your body the plaque forms and your overall health.

How common is peripheral artery disease?

PAD is common, affecting between 8 and 12 million Americans. However, healthcare providers sometimes don’t diagnose or treat PAD enough. Actual numbers are probably higher.

How does peripheral artery disease affect my body?

The typical symptom of PAD is called claudication, a medical term for pain in your leg that starts with walking or exercise and goes away with rest. The pain occurs because your leg muscles aren’t getting enough oxygen.

The dangers of PAD extend well beyond difficulties in walking. Peripheral artery disease increases the risk of getting a nonhealing sore of your legs or feet. In cases of severe PAD, these sores can turn into areas of dead tissue (gangrene) that make it necessary to remove your foot or leg.

What are the stages of peripheral artery disease?

Healthcare providers can use two different systems — Fontaine and Rutherford — to assign a stage to your PAD. The Fontaine stages, which are simpler, are:

• I: Asymptomatic (without symptoms).
• IIa: Mild claudication (leg pain during exercise).
• IIb: Moderate to severe claudication.
• III: Ischemic rest pain (pain in your legs when you’re at rest).
• IV: Ulcers or gangrene.