St. Joseph Office Park

C-100, 1401 Harrodsburg Rd, Lexington, KY 40504

859.278.4960  |  800.432.7226

Peripheral Artery Disease

Peripheral Artery Disease

What it is

Peripheral Artery Disease, or PAD, is the reduction of blood flow to your head, organs and limbs, especially the legs. Advanced PAD makes you more susceptible to heart attack and stroke, but PAD affects the legs so frequently, treatment of this condition is a particular specialty at Fayette Surgical Associates.


In its early stages, there may be no symptoms of PAD, but one of the first you may notice is the sensation of pain, fatigue, cramping, or weakness in your legs, usually while you are walking or engaged in other physical activities.  


More advanced PAD may cause pain even when you are resting. The pain is often experienced while you are in bed, and can be relieved by sitting up and dangling your feet to restore circulation with the help of gravity. Left untreated, PAD can cause serious issues because of your compromised circulation.  


The primary cause of PAD is atherosclerosis, or hardening of the arteries. There are other contributing factors:

• Age – the likelihood of PAD increases with age, especially after age 50

• Men have PAD more often than women

• Smoking

• Diabetes

• High blood pressure

• Lack of exercise

• Obesity  



If one of our vascular surgeons suspects you have PAD, one or more of several imaging tests may be ordered, including

• Ankle-Brachial Index (compares blood pressure in your arms and legs)

• Ultrasound

• Pulse Volume Recording

• MRA (m CT Scan

• X-ray exams

• Angiography

The tests can identify vascular blockages and determine the amount of blood flow to your legs.


Change Your Habits

If you have early-stage PAD, you can improve on your own by making some changes in your routines:

• If you smoke, stop

• If you are diabetic, manage your diabetes

• Manage your cholesterol

• Manage your weight

• Avoid fat and salt

• Exercise

• Most important: walk regularly


Your physician may also prescribe or recommend any of several medications:

• Blood pressure meds

• Cholesterol meds

• Blood clotting inhibitors


Though mentioned already as good exercise, a regular program of walking prescribed distances or time periods can make an enormous difference in your health – and walking is a usually a more attractive choice than many other treatments.

Angioplasty and stenting

Angioplasty is a minimally invasive procedure that opens blocked areas in your vessels.

A stent is a sleeve-like insert placed inside a vessel to keep it open.

Arteriography With Angioplasty and Stenting

Angioplasty and stenting may recommend by your vascular surgeon. This procedure is considered to be minimally invasive in comparison to open surgery. An angiogram is performed by your vascular surgeon.  He will insert a long, thin, flexible tube called a catheter into a small puncture over an artery in your arm or groin. The catheter is guided through your arteries to the blocked area. Once in place, a special balloon, which is attached to the catheter, is inflated and deflated several times. The balloon pushes the plaque in your artery against your artery walls, widening the vessel.  This is known as angioplasty. In some circumstances, your vascular surgeon may then place a tiny mesh-metal tube, called a stent, into the narrowed area of your artery to keep it open. The stent remains permanently in your artery. After this procedure, blood flows more freely through your artery. Other devices, such as atherectomy catheters may be deployed as well to help improve blood flow to your legs.


Bypass Surgery

Bypass surgery is exactly what it sounds like: one of your own vessels or an artificial vessel is used to divert blood flow around a blocked area.


In this procedure, the surgeon goes into a vessel and removes the material blocking blood flow.  


This is a last-resort option, but if blood flow is extremely compromised, living tissues begins to die, and gangrene can occur. Again, the earlier the diagnosis, the better the results. Even if gangrene is present, early detection can save lives.