Peripheral Artery Disease

For people with peripheral artery disease, doctors may provide drug therapy and invasive medical procedures which, in most cases, merely delay "end stage" damage — permanent physical damage that profoundly affects quality of life. Fortunately, peripheral artery disease is a potentially reversible health condition.

Contact us today and let us help you start the reversal process. In the meantime, consider the following facts about peripheral artery disease:

  • Peripheral artery disease (PAD) commonly refers to the narrowing or blockage of the arteries that carry blood from the heart to the limbs. PAD occurs when extra cholesterol and other fats collect in the walls of these arteries. This buildup, called plaque, narrows the arteries, often reducing or blocking blood flow.
  • Although PAD often refers exclusively to atherosclerosis of the arteries that carry blood to the legs, it can also exist in the arteries that carry blood from the heart to the arms, kidneys, and stomach.
  • Approximately 8.5 million Americans have PAD, including 5% of Americans over age 50, and 12% to 20% of Americans over age 60.

PAD is a potentially reversible health condition that Fettler Health can help you reverse. If it is not reversed, the following complications associated with PAD — some of which are also potentially reversible — have been known to occur:

pain when walking

Leg Pain with Exertion

When walking or exercising, the muscles in the legs require more blood flow in order to increase oxygen to the cells. Narrowed or blocked arteries caused by plaque buildup lead to decreased blood flow and decreased oxygen. Inadequate oxygen to the muscles of the legs can lead symptoms such as aching, burning, or cramping of the calf, thigh, hip, or buttock. These symptoms, taken together, describe the PAD-related complication called claudication which is pain and/or cramping in the lower body due to inadequate blood flow to the muscles. Intermittent claudication refers to one or more PAD-related symptoms that are prompted by physical exertion such as exercising or walking, and relieved by resting.

leg pain at rest

Leg Pain or Numbness at Rest

The most common PAD-related complication is claudication which refers to PAD-related pain and/or cramping in the buttock, hip, thigh, or calf. Claudication has two stages, intermittent claudication and severe claudication. Intermittent claudication refers to PAD-related leg pain and/or cramping that is prompted by physical exertion, and relieved by resting. By contrast, severe claudication refers to PAD-related leg pain and discomfort that occurs at rest. More specifically, severe claudication occurs as the artery becomes progressively narrow to the point at which the leg gets insufficient blood even when it is at rest. Once claudication becomes severe, the leg and foot may be cool, pale, and even numb. With severe claudication, foot and toe pain and tingling may disturb sleep. However, unlike the pain from a blood clot, severe claudication can be relieved by forcing blood down through the arteries by standing or dangling the leg over the edge of the bed. The term severe claudication is often used interchangeably with the terms critical limb ischemia and ischemic rest pain.

unhealed wound


The development of ulcers is a common consequence of impaired circulation caused by PAD. An ulcer is tissue erosion that can occur on the skin of the leg or foot. PAD-caused ulcers are painful and may lead to infections that can be life threatening. PAD patients who develop foot ulcers should seek immediate medical attention. Diabetes patients with normal circulation can also develop foot ulcers. However, ulcers experienced by diabetic patients are typically not painful but do require immediate medical treatment.



If a patient with PAD experiences severe leg pain at rest, otherwise referred to as severe claudication or critical limb ischemia, the survival of the leg is threatened. If this complication occurs, the associated decrease in blood flow can cause pain, nonhealing skin wounds, and/or gangrene. If these conditions occur and progress, and blood flow is not improved immediately, amputation may be required. For diabetes patients with diabetes and PAD, gangrene can occur with increased frequency for those with a lessened ability to feel skin injuries (a condition known as diabetic neuropathy). All this said, less than 5% of patients with PAD face a real risk of losing a foot or leg. This risk increases for patients who smoke, have diabetes, have reduced or no access to health care, or have avoided health care for other reasons.



A medication prescribed to PAD patients is cilostazol (Pletal). Cilostazol has been known to help individuals with intermittent claudication walk farther without pain. However, as with all medications, cilostazol has potential side effects. The most common side effects of cilostazol are headache, heart palpitations, nausea, and loose bowel movements. Cilostazol also interacts with a number of other drugs including certain antifungals, certain antibiotics, certain anti-seizure medications, and selective serotonin reuptake inhibitors (SSRIs).


Invasive Medical Procedures

Invasive medical procedures associated with the treatment of PAD and employed for the purpose of improving blood flow include angioplasty, stent placement, and vascular surgical procedures. Angioplasty is the process by which a clogged artery is opened with a balloon-tipped catheter. Stent placement refers to the process of inserting a metal mesh tube (a stent) designed to hold open an artery that has been opened via a balloon angioplasty procedure. Vascular surgical procedures may be used to either open a blocked artery or bypass the blockage altogether.

kidney damage

Complications of Angioplasty

Angioplasty is the process by which a clogged artery is opened with a balloon-tipped catheter. Because the dye (contrast medication) used to visualize the artery can also cause kidney damage, angioplasty is not appropriate for certain patients. Other complications of leg artery angioplasty include bleeding or bruising at the catheter insertion site, infection and damage to the vein or artery in the groin, and an allergic reaction to the dye.

leg blockage

Complications of Stenting

Stenting, or stent placement, refers to the process of inserting a metal mesh tube (a stent) designed to hold open an artery that has been opened via a balloon angioplasty procedure. A potential complication of both balloon angioplasty alone and stent placement is slow reblocking (restenosis). In the case of stent placement, restenosis presents as a reblockage of the artery within the stent. Another complication of stent placement is clotting of the stent which, while rare, can occur suddenly and usually soon after placement. In the end, it is a range of factors determine the amount of time that an artery stays open after angioplasty or stent placement. These factors include the location and severity of the original blockage, smoking, and high blood cholesterol.

heart attack

Complications of Bypass Surgery

With any surgical procedure on leg arteries, comes the risk of heart attack or stroke within the first 30 days following that procedure. Within the first 30 days, this risk may be as high as 3 to 5%, or even higher for those who smoke or have heart disease symptoms. Another complication is reblocking (restenosis) which is much more common in people who smoke or have diabetes or high blood cholesterol.

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