Peripheral vascular disease — often called peripheral artery disease, or PAD — is the buildup of plaque in the arteries that carry blood away from the heart, most commonly the arteries feeding the legs and feet. As those arteries narrow, the muscle downstream cannot get enough oxygen when it is asked to work.
The classic first symptom is claudication: a cramp or ache in the calf, thigh or buttock that comes on reliably after walking a certain distance and disappears within a few minutes of stopping. Many people quietly adjust their lives around it and never mention it to a physician. Later signs are harder to ignore — pain in the foot at rest or at night, coldness or numbness, hair loss over the shin, toenails that stop growing, and cuts on the foot that will not close.
PAD also carries a message about the rest of the body. Plaque in the leg arteries usually means plaque elsewhere, which is why a PAD diagnosis meaningfully raises the risk of heart attack and stroke. Treating the leg is only part of the job; the other part is aggressive control of the things driving the plaque — smoking above all, then blood pressure, cholesterol and diabetes.
What the procedure involves
Non-invasive testing first
We start with an ankle-brachial index and arterial duplex ultrasound. These are painless, take under an hour, and tell us how much flow is actually reaching the foot.
Angiography when it's warranted
If intervention is likely to help, a catheter angiogram maps the blockage precisely — where it is, how long it is, and how calcified.
Reopening the artery
Through the same catheter we can balloon the narrowing open (angioplasty), shave or drill out calcified plaque (atherectomy), deliver a drug-coated balloon, or place a stent where the vessel needs scaffolding.
Protecting the result
Reopening an artery buys time; keeping it open requires medical therapy, a walking program and, where relevant, stopping smoking. We build that plan with you rather than handing you a pamphlet.