Lower extremity PAD is peripheral arterial disease (PAD) that occurs in the blood vessels of the legs and/or feet. PAD is a form of atherosclerosis – a progressive disease that involves the hardening and narrowing of the arteries due to a gradual buildup of plaque.

Whereas coronary artery disease (CAD) involves the heart’s coronary arteries, PAD occurs outside of the heart. Because it is similar to CAD, PAD is an important risk factor for heart disease. Other forms of PAD include cerebrovascular disease, renal artery stenosis and mesenteric arterial disease.

The primary symptom of lower extremity PAD is intermittent claudication, a type of pain in the leg that occurs during activity, such as walking. The pain is caused by inadequate oxygen supply to the legs, which may occur during physical activity. When physical activity stops, the pain often stops as well. In most cases, the symptoms are mild. In severe cases, however, patients may experience pain while at rest (rest pain) or pain due to tissue loss or gangrene. Advanced cases of PAD can lead to leg amputation as the tissue below the blockage begins to die.

Diagnosis of PAD typically involves a painless measurement called an ankle-brachial index (ABI), in which the blood pressure in the legs is compared to the blood pressure elsewhere in the body. It may also include more complex tests such as duplex imaging, magnetic resonance angiogram (MRA) and/or an angiogram. Treatment often involves medications (e.g., antiplatelet agents), risk factor modification and exercise. More invasive treatments, such as catheter-based procedures and bypass surgery, are also available.

The symptoms of PAD are not inevitable results of the aging process. However, the likelihood of developing PAD does increase with age, which is an uncontrollable risk factor. Other uncontrollable risk factors for this condition include gender, ethnicity and family history.

Risk factors that can be modified include:

Researchers find that controlling these risk factors (particularly smoking) can greatly reduce the risk of PAD.