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Peripheral Arterial Disease (PAD)

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Peripheral artery disease is a subset disease of vascular disease

Also referred to as peripheral arterial disease (PAD), which develops when excessive plaque buildup on the artery walls, causing narrowing of the arteries. The arteries deliver oxygen-rich blood from the heart to other parts of the body. When plaque builds up, it usually restricts the flow of blood, oxygen, and glucose. The obstruction causes pain in the leg as the muscles and tissues are starved for oxygen and other nutrients from the blood. While the pain usually occurs in your legs primarily, it can also be felt in other parts of the body, including your arms, stomach, hip, head, and kidneys.

Are You at Risk for Peripheral Arterial Disease (PAD)?

In most cases, the PAD symptoms are on the lower extremities. You may experience some pain, craping, or tiredness in your hip or leg muscles when climbing stairs or walking. However, the pain usually goes away with rest, only to resurface when you start walking again. Individuals suffering from peripheral arterial disease are at a high risk of coronary artery disease, stroke, or heart attack. Even worse, if left untreated, the condition can lead to gangrene and amputation.

The most common symptom of Peripheral arterial disease is claudication. The fat and cholesterol build up on the artery walls cause a lack of blood flow, causing a condition referred to as ischemia. Ischemia is a condition that results when there is a greater demand for oxygen than the supply.

Claudication is a condition that causes cramping in the legs and buttocks. As mentioned, the pain and clamping flares up when you start to walk and subsides when you rest. Intermittent claudication affects about 50 percent of individuals suffering from peripheral artery disease. Some of the other common symptoms include loss of hair around the ankles, numbness or coldness in your feet.

Pain and cramping while walking may lead to a more sedentary lifestyle, meaning that the individual will burn few calories and add weight. An increase in weight also increases cholesterol, blood pressure, and other heart disease risk factors. The claudication severity often varies from mild discomfort to debilitating pain, making it hard for you to walk or perform other types of physical activities. Other common symptoms of the peripheral arterial disease include;

  • In extreme cases, an open wound or ulcer occurs on your toes or feet. These extreme cases lead to non-healing ulcers. The ulcer can progress to gangrene, making it hard for you to walk. In such a scenario, immediate medical attention is necessary.
  • Weakness or numbness in your legs
  • Coldness in your lower feet, especially when you find one foot is colder than the other one.
  • Experiencing pain in your feet or toes while you are resting
  • Sores on the legs, feet, and toes that do not heal
  • Slower toenails growth
    Change in the color of your feet
  • Erectile dysfunction in men can be treated by prostate arterial embolization (PAE), which also treats benign prostatic hyperplasia (BPH)
  • Weak pulse in your feet or legs
  • Developing shiny skin on your legs
  • Having pain in your arms, especially when writing, knitting, or performing manual tasks

As the peripheral disease progresses, you may start to experience pain even when you are lying down. In extreme cases, the pain becomes intense enough to distract your sleep. Resting your legs by hanging them at your bed edge or walking around the room helps stimulate blood flow, relieving the pain temporarily

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The high amputation rate among diabetics is attributable, in part, to the neuropathic effects of the ailment. Neuropathy leads to a lack of pain perception in the affected individual, meaning that they may be entirely unaware of minor wounds on their feet and legs in good time, allowing for their infection or repeat injury. It is also made more likely by the immunosuppressive effects of the condition, which makes the patient more vulnerable to infection.

Peripheral Arterial Disease – Diagnosis

At Pedes Orange County, we have highly trained physicians who offer a comprehensive diagnosis to develop customized treatments of Peripheral artery disease (PAD). We understand that no two patients’ conditions are similar. Our full-service vascular lab provides state-of-the-art testing to ensure that our physicians address each patient case quickly and accurately. Our doctors and nurses also have broad experience in this field and use advanced tools to achieve limb-saving results even for challenging, impaired patients. Our PAD diagnosis procedure involves the following.

To help diagnose PAD, our skilled doctor will start by doing a thorough physical examination. The doctor will also want to learn about your signs, symptoms, personal health history, risk factors, and family health history. The doctor will ask you several questions regarding your medical conditions, such as diabetes, heart disease, and kidney disease. They will also ask you whether you experience pain or cramps in your leg while walking or exercising.

The doctor will also ask about your family history of PAD and other heart diseases. You will also discuss your smoking habit, either current or in the past. After gathering the information, the doctor will proceed to perform a detailed physical examination. The process involves checking for weak pulses in your leg, listening for poor blood flow in the legs using a stethoscope. The physician will also check for any problems on your legs, such as sores, swelling, and pale skin.

Ankle-brachial index (ABI test) helps diagnose PAD. This test usually compares the blood pressure in your arm with the blood pressure in your ankle. The doctor usually uses a pressure cuff together with an ultrasound device. Sometimes, the physician may request you to walk on a treadmill and have the doctor take the readings before and immediately after the exercise. The procedure will help the doctor to capture the severity of the narrowed arteries.

Pedes Orange County doctors also use ultrasound-guided procedures to determine whether a specific vein or artery is blocked or opens. The procedure is non-invasive, meaning that you will not experience any pain. The technique visualizes the artery with sound waves that measure the blood volume that flows in the veins and arteries. After the procedure, the patients receive a thorough consultation. The doctor will recommend the most effective treatment option to help promote blood flow to the feet and leg.

The treatment will help reduce leg pain, promote healing of sores and increase the mobility of the affected limb. Doctors utilize two main ultrasound methods. The first method is the Doppler ultrasound utilized to locate areas with blockages or reduced blood flow. The procedure involves using a handheld device that sends sound waves through the arteries to measure how fast blood flows. The second method is the segmental Doppler pressure testing that checks various parts of the legs for blocked or narrowed arteries. The procedure is similar to the ABI test, but the ultrasound device will amplify the sound of blood flow, making it easy to measure blood pressure.

Angiography is minimal invasive testing that helps to visualize and diagnose blockages inside veins and arteries. In this procedure, the physician will insert a thin tube that injects a special dye that enables blood vessels to appear on an X-ray. As the dye is introduced to the arteries and veins, fluoroscopy imaging captures the detailed images to see the extent of blockages in the arteries.
Doctors also take a sample of your blood to measure the levels of cholesterol and triglycerides. Blood samples are also used to check for diabetes.
MRA tests are conducted to examine the structure of the arteries in your leg. However, the doctor will speak to you before using the procedure. Magnetic resonance angiography is not recommended for people with metal implants in their bodies.

Patient Story

Treatments for Peripheral Arterial Disease

The treatment for PAD has two main goals. One is to manage the symptoms, including leg pain, allowing you to resume your normal physical activities. The second one is to top the progression of atherosclerosis…

Are You at Risk for Peripheral Arterial Disease (PAD)?

See of you are at risk for peripheral arterial disease. It is a simple 7 questions quiz to see if you might be at risk for PAD.

Our Vascular Disease Physicians

The physicians at Pedes Orange County devote their lives to saving limbs and minimizing pain. Our conveniently located, state-of-the-art facility is designed for your comfort and utilizes cutting-edge technology to provide minimally invasive treatments. Our vascular surgeons and vascular specialists are board-certified and some of the best in Southern California. Personable staff members make every visit a positive experience, with short wait times and an efficient, streamlined process that ensures you leave feeling educated and confident that you are in good hands.

J. Joseph Hewett, M.D.

Vascular Specialist

Neil K. Goldstein, M.D.

Vascular Specialist

Derrick Tran, MD

Vascular Specialist

Mohammad Jaber, M.D.

Vascular Surgeon

Why Choose Pedes Orange County

At Pedes Orange County, we offer customized arterial treatment to help minimize pain, promote fast sore healing, and, most importantly to avoid amputation. All our treatments a geared towards improving the overall quantity of our patients’ lives. We aim at offering a fast solution to stop the disease progression within the shortest time possible, allowing you to get back on your feet in no time.

We prioritize our patient needs. Through our vast experience in this field, we take pride in offering precise treatment that stops the disease progresses quickly and offer advice on lifestyle changes that prevent the condition from resurfacing.

It is our goal to ensure that you live a happy, healthy life. As such, our patient care does not stop after the end of a procedure in our clinic. We also schedule follow-up appointments to evaluate the recovery and results. Our friendly physicians are also more than happy to help you with any concerns about our diagnostics tests and treatment procedures. Please schedule an appointment today, and we promise to deliver the best possible experience and results.

What to Expect from Your Visit to Pedes


Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.


Once we review the results of your diagnostic tests, our physicians will help you develop a plan to provide you with the best treatment for your disease.


Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.

Follow up

Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.

Treatment Options

Learn more about our treatment options

What to Expect

Learn more about our what to expect

Vascular Disease

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