Peripheral Artery Disease

Peripheral artery disease (PAD) is a progressive narrowing of the blood vessels most often caused by atherosclerosis, the collection of plaque or a fatty substance along the inner lining of the artery wall. Over time, this substance hardens and thickens, which may interfere with blood circulation to the arms, legs, stomach and kidneys. Blood circulation to the brain and heart may be reduced, increasing your risk for stroke and heart disease.

While PAD can affect anyone, one of out three diabetics over age 50 has the disease.

If untreated, it may result in severe disability and in serious cases, leg amputation. Up to 70 percent of all limb amputations not caused by trauma are performed on diabetics with severe PAD.

While many patients with peripheral artery disease (PAD) have mild symptoms or no symptoms at all, about one in 10 experiences painful cramping or fatigue in the legs, hip, thigh or calf muscles after walking or climbing stairs, which is relieved by a short period of rest. This condition is called intermittent claudication.

Other symptoms include:

  • Change in the color of the legs
  • Changes in the toenails
  • Coldness in the lower leg or foot, especially compared to the other leg
  • Hair loss on the feet and legs
  • Leg numbness or weakness
  • Sores on the toes, feet or legs that won't heal

In making a diagnosis of peripheral artery disease (PAD), your doctor will take your complete medical history and conduct a physical exam. You will also have one or more of the following tests to confirm a diagnosis:

  • Ankle-Brachial Index — (ABI) is a simple way to measure the blood flow in your legs using an ankle cuff, which the doctor inflates until the beat of your pulse is no longer heard. Pressure is then released from the cuff and your blood pressure is recorded.
  • Duplex Ultrasound — A test to see how blood moves through your arteries and veins
  • Computed Tomography (CT) — Angiography is used to visualize the arteries bringing blood to your brain, lungs, kidneys, arms and legs.
  • Magnetic Resonance Angiography (MRA) — An exam of the blood vessels.

You may also have blood tests to measure your cholesterol, homocysteine, an amino acid in the blood, and certain proteins.

Cardiologists, cardiac and vascular surgeons, interventional radiologists and other specialists work together to provide the most effective treatments — many of them developed at UCSF — for peripheral artery disease, or PAD.

Your treatment will depend on the severity of your PAD. Many patients can be managed with non-invasive therapies such as lifestyle changes, medication, or both. If your condition does not respond to these approaches, surgery may be necessary. In the most advanced cases, limb amputation may be required.

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Heart & Vascular Center

Vascular & Endovascular Surgery
400 Parnassus Ave., Suite 501
San Francisco, CA 94143
Phone: (415) 353-2357
Fax: (415) 353-2669
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Vascular Laboratories at Parnassus
505 Parnassus Ave., Eighth Floor, Room M-830A
San Francisco, CA 94143
Phone: (415) 353-1286
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Limb Preservation Center
400 Parnassus Ave., Room A-501
San Francisco, CA 94143
Phone: (415) 353-2357
Fax: (415) 353-2669
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