Peripheral Arterial Disease Specialist in Maryland, New Jersey, & Virginia

What is Peripheral Arterial Disease?

Peripheral Arterial Disease (PAD) is a severe vascular condition in which plaque accumulates in the arteries, limiting blood flow to the limbs, head, and organs. Arteries are essential for circulating oxygen-rich blood from the heart and lungs to various body parts. In severe cases, PAD can result in critical conditions, including the need for amputation. Healthcare professionals focus on preventing limb loss and improving the quality of life for patients through both non-invasive and invasive vascular treatments.

PAD is characterized by the accumulation of plaque in the arteries, which restricts blood flow beyond the affected point. Plaque is composed of fat, cholesterol, calcium, and other substances found in the blood. Over time, this plaque hardens and narrows the arteries, reducing or blocking blood flow to the organs and limbs. PAD commonly affects the arteries in the legs but can also impact arteries supplying blood to the head, arms, kidneys, and stomach.

What Causes Peripheral Arterial Disease?

The primary cause of PAD is atherosclerosis, a condition where plaque builds up on the artery walls. Several factors contribute to the development of atherosclerosis, including:

  • Smoking
  • High Cholesterol
  • High Blood Pressure
  • Diabetes
  • Sedentary Lifestyle
  • Age
  • Family History

Peripheral arterial disease (PAD) primarily results from atherosclerosis, where plaque accumulates on the artery walls. Critical contributors to atherosclerosis include smoking, high cholesterol, high blood pressure, diabetes, a sedentary lifestyle, advancing age, and family history.

Understanding these factors is essential for the prevention and effective management of PAD, highlighting the importance of lifestyle modifications and regular medical check-ups to mitigate the risks associated with this vascular severe condition.

What Are the Symptoms of Peripheral Arterial Disease?

PAD symptoms can vary from mild to severe, depending on the extent of artery blockage. Common symptoms of Peripheral Arterial Disease include:

  • Pain, cramping, or fatigue in the legs or hips while walking or climbing stairs, otherwise called claudication.
  • Reduced blood flow caused by Peripheral Arterial Disease can cause erectile dysfunction in men.
  • Severe PAD can cause leg pain even when resting.
  • Sores on the legs or feet that do not heal properly.

Uncommon symptoms of peripheral arterial disease can include but aren’t limited to:

  • Pain in the arms while using them, indicating PAD in the arms.
  • Severe tissue damage leads to gangrene in the extremities.
  • The affected limb may feel cold or discolored due to poor blood flow.

Advanced Symptoms and Complications for peripheral arterial disease include but aren’t limited to:

  • Critical limb ischemia, where blood flow is severely restricted.
  • Severe pain in the feet or legs, particularly at night.
  • Persistent sores that do not heal.
  • Tissue death due to lack of blood flow, potentially leading to amputation.


Peripheral Arterial disease is a serious condition that requires early diagnosis and treatment to prevent severe complications, including limb loss. Understanding the risk factors, symptoms, and treatment options can help manage and prevent PAD. Regular check-ups and lifestyle modifications play a crucial role in reducing the risk and improving the quality of life for those affected by PAD. If you experience symptoms of PAD, consult a healthcare professional for a comprehensive evaluation and appropriate management plan.


Am I at Risk for PAD?

Several factors increase the likelihood of developing PAD:

  • Age
  • Current or former smokers have a higher risk of PAD.
  • Diabetes significantly increases the risk of developing PAD.
  • Hypertension (high blood pressure) is a critical risk factor.
  • Elevated cholesterol levels contribute to plaque buildup.
  • Excess body weight is associated with several risk factors for PAD.
  • A family history of PAD or other vascular diseases can increase your risk.

Understanding these factors is essential for the prevention and effective management of PAD, highlighting the importance of lifestyle modifications and regular medical check-ups to mitigate the risks associated with this severe vascular condition.

How is Peripheral Arterial Disease Diagnosed and Treated?

If you have diabetes or hypertension, it's essential to talk to your vascular specialist if you're experiencing any symptoms or have concerns about peripheral arterial disease. Diagnosing PAD involves a detailed medical history, physical examination, and specific diagnostic tests.

Treating Peripheral Arterial Disease

The treatment goals for PAD are to manage symptoms, improve quality of life, and prevent complications. Your vascular specialist will evaluate your current state and medical history to recommend the best treatment. 

Lifestyle Changes

Some patients can manage peripheral arterial disease through lifestyle changes such as quitting smoking and getting regular exercise, including cardiovascular exercise like walking, cycling, or swimming for 20-30 minutes at least three times a week.

Other lifestyle changes patients with PAD can make to decrease their risks are adopting a healthy diet low in saturated fats and high in fruits, vegetables, and whole grains. Staying active and focusing on a healthy diet can help patients manage and maintain a healthy weight, another risk factor for peripheral arterial disease.

Medication

Depending on your risk factors and underlying medical conditions, your vascular specialist may recommend medication to prevent blood clots, including aspirin, clopidogrel (Plavix), ticagrelor (Brilinta), or rivaroxaban (Xarelto). 

Minimally Invasive Procedures for Peripheral Arterial Disease

Angioplasty involves inserting a small balloon at the site of the blocked artery and inflating it to widen the artery and improve blood flow. Often, a stent (a small mesh tube) is placed in the artery to keep it open after the procedure.

Atherectomy is a procedure that removes plaque from the artery walls. It involves using a catheter with a sharp blade or a laser at its tip to remove the plaque. This procedure can be beneficial for treating arteries that are difficult to access with other methods.

Arterial stenting involves placing a small wire mesh tube, called a stent, inside the artery. The stent is a scaffold that keeps the artery open and ensures adequate blood flow. Stents are often used in conjunction with angioplasty.


Minimally invasive treatments offer effective options for managing Peripheral arterial disease. They aim to restore proper blood flow, alleviate symptoms, and improve quality of life with fewer risks and quicker recovery times. Discussing these options with a vascular specialist can help determine the best treatment plan tailored to individual needs and conditions.

Surgical Treatments for Peripheral Arterial Disease


Your vascular specialist may recommend bypass surgery for patients who are not responding to lifestyle changes, medication, or conservative treatment methods. Bypass surgery involves creating a bypass around the blocked artery using a graft from another part of the body.

Peripheral arterial disease (PAD) does not go away on its own. It is a chronic condition that typically requires medical intervention and lifestyle changes to manage effectively. Without treatment, PAD can progress and lead to serious complications, including severe pain, ulcers, and even limb loss due to gangrene.

Early diagnosis and a comprehensive management plan involving medication, lifestyle changes, and sometimes surgical procedures are essential to control symptoms, improve quality of life, and prevent the disease from worsening. Regular follow-ups with a healthcare provider are crucial to monitor the condition and adjust treatment as necessary.

How Do I Decrease My Risk for PAD?

Patients at risk for developing peripheral arterial disease should talk to their vascular specialist about lifestyle changes they can make to improve their overall and vascular health. Some lifestyle changes that decrease your risk for peripheral arterial disease include but aren’t limited to:

  • Quit smoking and avoid all tobacco products.
  • Engage in regular physical activity.
  • Eat a balanced diet low in saturated fats and high in fiber.
  • Keep diabetes, hypertension, and cholesterol levels under control.
  • Visit your healthcare provider regularly for check-ups and screenings.

Consult with your vascular specialist to create a personalized plan to enhance your overall and vascular health, significantly decreasing your risk for PAD. If you have any underlying conditions, such as a history of deep vein thrombosis, high blood pressure, or diabetes, do not take over-the-counter supplements or start workout programs without first consulting your vascular specialist or primary care provider.

Peripheral Arterial Disease Treatment at Center for Vascular Medicine

If you experience any symptoms of Peripheral Arterial Disease or have risk factors such as diabetes or hypertension, consult a healthcare professional for a comprehensive evaluation and management plan. Take proactive steps to improve your vascular health through lifestyle modifications, regular exercise, and a healthy diet.

Visit one of our Center for Vascular Medicine locations for expert diagnosis and care. Early intervention can significantly improve the management of PAD and your quality of life.

Schedule an appointment with Center for Vascular Medicine and take the first step towards better vascular health. Visit one of our Center for Vascular Medicine locations for a thorough diagnosis and expert care. Early intervention can significantly improve the management and outcome of PAD.

PAD Prevention

Like with most other diseases, the first step is often to make lifestyle changes such as eating a healthy diet and exercising more often. Smoking cessation is also frequently recommended because it has been closely linked with the development of vascular diseases. Other lifestyle changes often include paying closer attention to blood sugar levels, blood pressure, and cholesterol. 

Disease Progression

Doctors are recognizing that PAD is a much more common problem than originally thought. According to published research, more than 1 in 5 people older than age 70 have PAD. Fewer than half of the patients with PAD know they have a problem. Many patients with PAD do not have leg symptoms and can only be diagnosed by a doctor’s examination or by the ABI test.

Patients with leg pain caused by PAD may have a limited ability to walk, exercise, perform their jobs, go shopping, or clean their homes. Leg pain from PAD can worsen a person’s quality of life. Many treatments for claudication are available that may greatly improve symptoms of PAD, but the first step in treatment is diagnosis.

Most important, patients who have PAD are more likely to have blockages in other arteries of the body, especially the arteries of the heart and brain. Patients with PAD are 3 to 6 times more likely to have a heart attack or stroke than are patients without PAD.

PAD symptoms will worsen if left untreated by a medical specialist or neglecting lifestyle changes. Most importantly patients should be aware of the increased risk of heart attack or even limb loss with a diagnosis of PAD. Medical attention should be sought sooner rather than later. 

Vascular Doctor Explains PAD

This article is a comprehensive overview of Peripheral Arterial Disease (PAD). However, it should not take the place of speaking with a physician. If you are experiencing any of the symptoms listed above, or know someone who is, contact us today to schedule a consultation.

 

You can also view other vascular diseases below:

Pelvic Congestion Syndrome

Deep Vein Thrombosis

May-Thurner Syndrome

Chronic Venous Insufficiency

Post-Thrombotic Syndrome

FAQ’s

PAD is a serious disease that needs immediate attention. Living with this vascular disease without treatment decreases your chances for a long life dramatically. For severe cases, this decreases your chances of longer life even more dramatically because your risk of suffering from a heart attack can be 6 times higher than normal. 

Patients with PAD usually have a tingling sensation, tightness in legs or lower extremities, fatigue, or pain during exertion like walking long periods. Most patients have these symptoms in the calf area. Please consult your primary care doctor or vascular specialist to determine the cause of your symptoms. 

PAD can reduce the amount of blood flow that reaches the toes. Common signs of this include discoloration, coldness, numbness, or pain of the toes. Skin and nails of the toes may become dry and rough, and wounds may not heal efficiently. 

PAD can reduce the amount of oxygen reaching the skin and increase the amount of inflammation in blood. These factors can lead to the rupture of small blood vessels and the development of scar tissue, making skin look darker and feel rougher.  

Some patients may be able to reduce plaque build-up in the arteries by lowering their cholesterol with diet and exercise, and/or medication. There is some research to suggest that a plant-based diet may be most helpful. Exercise can also help to reopen blocked arteries, or to develop bypasses around blockages in the arteries. Quitting smoking can reduce inflammation inside the arteries and slow down plaque development

Plaque in the arteries is caused by the accumulation of fatty cells along the vessel wall which are eventually turned into connective tissue and calcified. These plaques create a rough surface which can cause even more plaque to accumulate. This process begins due to a complex reaction involving inflammation within the arteries.  

Early PAD may not cause any signs or symptoms. As the disease progresses, people may develop pain in their legs, hips, or buttocks. Some PAD patients may also develop numbness or coldness in the feet or toes. Severe cases of PAD can cause painful, slow-healing or non-healing wound of the legs or feet.  

Dr. Sanjiv Lakhanpal

Dr. Sanjiv Lakhanpal

Dr. Sanjiv Lakhanpal published in several medical research journals through the Lakhanpal Vein Foundation to help educate and raise awareness for vascular disease. He has been practicing medicine for 25 years, and is the founder of The Center for Vascular Medicine.