Peripheral artery disease is a condition of the blood vessels that leads to narrowing and hardening of the arteries that supply the legs and feet.

The narrowing of the blood vessels leads to decreased blood flow, which can injure nerves and other tissues.

Peripheral artery disease is caused by arteriosclerosis, or "hardening of the arteries." This problem occurs when fatty material (plaque) builds up on the walls of the arteries. This causes the arteries to become narrower. The walls of the arteries also become stiffer and cannot widen (dilate) to allow greater blood flow when needed.

As a result, when the muscles of the legs are working harder (such as during exercise or walking) they cannot get enough blood and oxygen. Eventually, there may not be enough blood and oxygen, even when the muscles are resting.

Peripheral artery disease is a common disorder that usually affects men over age 50. People are at higher risk if they have a history of:

  • Abnormal cholesterol
  • Diabetes
  • Heart disease (coronary artery disease)
  • High blood pressure (hypertension)
  • Kidney disease involving hemodialysis
  • Smoking
  • Stroke (cerebrovascular disease)
  • The classic symptoms are pain, achiness, fatigue, burning, or discomfort in the muscles of the feet, calves, or thighs.
  • These symptoms usually appear during walking or exercise and go away after several minutes of rest.

At first, these symptoms may appear only while walking uphill, walking faster, or walking for longer distances. Slowly, these symptoms come on more quickly and with less exercise. Legs or feet may feel numb even at rest. The legs also may feel cool to the touch, and the skin may look pale. When peripheral artery disease becomes severe, one may have:

  • Impotence
  • Pain and cramps at night
  • Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful
  • Pain that is worse when the leg raised and improves when the leg is dangled over the side of the bed
  • Skin that looks dark and blue
  • Sores that do not heal


Majority of the blocks can be diagnosed by simple clinical examination- inability to feel the pulses in the foot.

Arterial blocks can be diagnosed by color Doppler a noninvasive painless method.

Angiogram provides a road map of the arterial tree and it helps to plan the method of treatment.

It is important for the high risk population namely smokers, those with diabetes, high blood pressure,and high cholesterol to have periodic check up of the vascular system to pick up vascular blocks early so that corrective measures can be taken before complications set in.

Treatment options

Medical: All patients with mild blocks can be treated medically.

Stopping smoking and all forms of tobacco is the most important step towards recovery Regular exercises and walking helps to improve the blood flow and control sugar and cholesterol. Proper foot wear and foot care Blood thinners like aspirin ,clopidogrel Control of risk factors like sugar, blood pressure and cholesterol Life style modification Surgical: Those who have advanced blocks presenting with gangrene or severe pain require intervention. If the block is long bypass surgery can be done. Most often patients own vein is used for the leg bypasses. Artificial grafts can be used if the vein is not available.

Endovascular Treatment

Nowadays majority of the arterial blocks can be opened up by balloon angioplasty without resorting to open surgery . In balloon angioplasty the balloon is positioned across the block or narrowed artery and dilated . This causes the plaque(Fatty material deposited in the wall) to be compressed and the arterial wall is stretched. Majority of the blocks to the limb vessels can be opened by balloon angioplasty. In some cases the block is hard and the artery collapses again after the balloon is removed. In these cases a metal mesh(stent) is kept inside to prevent the wall from collapsing again. Recently a stent is also covered with a thin fabric so that a smooth lining can be achieved for the arterial wall. These stent grafts are used for treating aneurysms(abnormal dilatation of the artery).

Nowadays angioplasty is offered as the treatment of choice for treating limb ischemia.