Peripheral artery disease (PAD) is a common circulation problem. It develops when plaque builds up inside the arteries that carry blood to the legs and feet.

Reduced blood flow may cause leg discomfort while walking, numbness, cold feet, pain at rest, or wounds that are slow to heal. Some people have few or no noticeable symptoms.

PAD is also an important warning sign. It may mean that plaque has developed in other arteries, including those supplying the heart and brain. This increases the risk of heart attack and stroke.

At Flow Heart & Vascular in Mesa, Arizona, Nachiket J. Patel, MD, FACC, FSCAI, evaluates and treats patients with suspected or established PAD. The practice welcomes patients from Mesa, Gilbert, Chandler, Queen Creek, San Tan Valley, and communities throughout the East Valley and greater Phoenix area.

What Is Peripheral Artery Disease?

Peripheral artery disease is also called peripheral arterial disease. It is most often caused by atherosclerosis.

Atherosclerosis occurs when cholesterol, fat, calcium, and other materials collect inside an artery. This buildup is called plaque. Over time, plaque can narrow or block the artery and reduce blood flow.

PAD most often affects the legs and feet. Symptoms can range from mild discomfort during activity to severe pain, nonhealing wounds, or tissue damage.

Early diagnosis matters. Treatment can improve walking, protect the legs and feet, and reduce cardiovascular risk.

Common Symptoms of PAD

The classic symptom of PAD is called claudication. It may feel like aching, cramping, heaviness, weakness, or fatigue in the leg.

The discomfort usually begins during walking or exercise. It often improves within a few minutes of rest.

Possible symptoms include:

Calf, thigh, buttock, or foot discomfort during activity
Leg weakness or fatigue while walking
Coldness in one foot or lower leg
Numbness or tingling in the legs or feet
Weak or absent pulses in the feet
Shiny skin or loss of hair on the legs
Slow-growing toenails
Pale, blue, or discolored skin
Sores on the toes, feet, or legs that heal slowly
Foot or toe pain while resting, especially at night

Not everyone with PAD experiences typical leg pain. Diabetes, neuropathy, arthritis, and limited mobility can make the symptoms less obvious.

Some people unknowingly reduce their activity to avoid discomfort. They may therefore believe they have no symptoms.

When PAD May Be an Emergency

Severely reduced blood flow can threaten a leg or foot.

Contact a medical professional promptly if you develop a new wound, persistent pain at rest, or progressive discoloration.

Call 911 or seek emergency care for sudden, severe leg or foot pain accompanied by:

A foot or leg that becomes cold, pale, or blue
Sudden numbness or weakness
Loss of movement
A suddenly absent pulse

These symptoms may indicate acute limb ischemia. This is a medical emergency that requires immediate evaluation.

Who Is at Risk for PAD?

PAD becomes more common with age. However, it can also affect younger adults who have major cardiovascular risk factors.

Important risk factors include:

Current or previous tobacco use
Diabetes
High blood pressure
High cholesterol
Chronic kidney disease
Obesity
Physical inactivity
Coronary artery disease
A previous heart attack or stroke
A family history of cardiovascular disease
Increasing age

Smoking and diabetes are especially important risk factors for advanced PAD. Having several risk factors increases the likelihood of developing the disease.

How Is PAD Diagnosed?

The evaluation begins with a conversation about your symptoms and medical history. Dr. Patel will ask when the discomfort occurs, what makes it better, and how it affects your activities.

The physical examination may include checking the pulses, skin, temperature, and color of both legs. Any wounds or areas of concern will also be examined.

Testing may include the following:

Ankle-Brachial Index

An ankle-brachial index, or ABI, compares the blood pressure at your ankle with the pressure in your arm.

A lower pressure at the ankle can indicate reduced blood flow. An exercise ABI may be helpful when symptoms suggest PAD but the resting result is normal.

Toe-pressure testing may provide more information in certain patients. This can be especially useful when the ankle arteries are difficult to compress.

Arterial Ultrasound

A lower-extremity arterial ultrasound uses sound waves to examine blood flow. It can help locate an artery that is narrowed or blocked.

Ultrasound does not use radiation. It can also help estimate the severity of the disease.

CT or MR Angiography

CT angiography and MR angiography create detailed pictures of the arteries.

These tests may be ordered when more information is needed. They can also help plan treatment.

Catheter Angiography

A peripheral angiogram shows the arteries using a catheter and contrast material.

It provides detailed information about the location and severity of a blockage. In selected cases, treatment can be performed during the same procedure.

Not every patient needs every test. Dr. Patel will select testing based on your symptoms, examination, kidney function, and previous results.

Treatment for Peripheral Artery Disease

Treatment is based on your symptoms, the location of the disease, and your overall health. It also depends on how much PAD limits your daily life.

Treatment has two main goals:

Improve blood flow, walking ability, and quality of life
Reduce the risk of heart attack, stroke, and disease progression

Reducing Cardiovascular Risk

Treating the underlying atherosclerosis is essential, even when leg symptoms are mild.

Your treatment plan may include:

Stopping tobacco use
Cholesterol-lowering treatment
Blood-pressure control
Diabetes management
Antiplatelet or other vascular medication when appropriate
Regular physical activity
A heart-healthy eating pattern
Preventive foot care

Medication decisions must be individualized. Do not start, stop, or change aspirin, clopidogrel, cholesterol medication, or another prescription without medical guidance.

Structured Walking and Exercise

A structured walking program is an important treatment for many patients with claudication.

The program usually alternates periods of walking and rest. Over time, it can improve walking distance, endurance, and quality of life.

The safest program depends on your health and symptoms. Patients with wounds, pain at rest, or unstable heart symptoms should receive medical guidance before beginning an exercise program.

Medication for Walking Symptoms

Medication may help selected patients walk farther with less discomfort.

These medicines are not appropriate for everyone. The benefits and risks depend on your medical history, including whether you have heart failure.

Catheter-Based Treatment

A minimally invasive procedure may be considered when PAD continues to limit daily activities despite appropriate medical and exercise treatment.

A procedure may also be needed when poor circulation causes pain at rest, a nonhealing wound, or a threat to the limb.

Treatment options may include:

Balloon angioplasty to widen a narrowed artery
Drug-coated balloon treatment in selected arteries
Atherectomy to modify or remove plaque in selected cases
Stent placement to help keep an artery open
Treatment of more than one diseased area when appropriate

These treatments are performed through a small catheter placed into an artery. The best technique depends on the location, length, and type of blockage.

Not every blockage needs a procedure. Treatment should be based on symptoms and expected benefit—not an imaging result alone.

A procedure may be performed in an office-based lab or hospital. The safest setting depends on the complexity of the case, the patient’s health, and insurance requirements.

Surgical Treatment

Some long or complex blockages are better treated with surgical bypass.

When surgery is the best option, Dr. Patel can coordinate a vascular-surgery evaluation and continue managing your cardiovascular care.

Why Choose Flow Heart & Vascular?

Dr. Patel is an interventional cardiologist with experience treating both heart and peripheral vascular disease.

This combined perspective is valuable because PAD is not only a leg-circulation problem. It is part of a broader cardiovascular condition.

The goal at Flow Heart & Vascular is to identify the cause of your symptoms and create an individualized plan. Recommendations may include testing, exercise therapy, medication, catheter-based treatment, or surgical evaluation.

What to Expect at Your Appointment

Please bring an updated medication list and any previous vascular reports or images.

During your appointment, we will discuss:

Where your symptoms occur
When the symptoms begin
How far you can walk before stopping
Whether rest relieves the discomfort
Any wounds, discoloration, numbness, or nighttime pain
Tobacco use and other cardiovascular risk factors
Previous vascular testing or treatment
How the symptoms affect your daily activities

After the evaluation, Dr. Patel will explain whether testing is needed. He will then review the available treatment options with you.

Frequently Asked Questions About PAD

Is PAD the same as poor circulation?

PAD is one important cause of poor circulation. However, leg symptoms can also come from venous disease, neuropathy, arthritis, or spinal conditions.

An evaluation can help identify the actual cause.

Does all leg pain while walking mean PAD?

No. Muscle problems, arthritis, nerve compression, and spinal disease can cause similar discomfort.

PAD is more concerning when symptoms follow a predictable pattern with walking and improve with rest. Weak pulses, cold feet, skin changes, and nonhealing wounds also raise concern.

Can someone have PAD without symptoms?

Yes. Some people have no recognizable symptoms.

Others reduce their activity without realizing it. Diabetes and neuropathy can also make PAD symptoms harder to notice.

Can PAD be cured?

The underlying atherosclerosis usually cannot be removed completely.

However, treatment can slow its progression and reduce cardiovascular risk. Treatment can also improve walking, relieve symptoms, help wounds heal, and protect the limb.

Is walking safe for someone with PAD?

Walking is beneficial for many people with stable claudication. It is an important part of PAD treatment.

Patients with wounds, pain at rest, sudden symptoms, or unstable heart problems should obtain individualized guidance first.

When is a procedure needed?

A procedure may be considered when PAD significantly limits daily activities despite medical and exercise treatment.

Rest pain, nonhealing wounds, or threatened tissue may require more urgent restoration of blood flow.

Does PAD increase the risk of heart attack or stroke?

Yes. PAD is a form of atherosclerotic cardiovascular disease.

Controlling cholesterol, blood pressure, diabetes, tobacco exposure, and other risk factors is therefore an essential part of treatment.

Medical Review and Sources

Medical information reviewed by Nachiket J. Patel, MD, FACC, FSCAI. Last reviewed July 2026.

This page provides general educational information. It does not replace an individualized medical evaluation. Call 911 for a medical emergency.

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If you are experiencing these symptoms or have concerns about your heart or circulation, schedule an appointment with Flow Heart & Vascular today.

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Peripheral Artery Disease (PAD)