Peripheral artery disease (PAD) is a condition in which blockages develop in the major arteries of the limbs, usually in the legs. These blockages prevent blood from getting to parts of the leg that need it. PAD causes a number of challenging symptoms like pain when exercising, leg discomfort, and difficult-to-heal sores on the foot or the ankle in severe cases. It’s important for individuals with PAD to recognize that PAD is a very serious condition that can require amputation if the disease is left untreated.
PAD is treated most effectively by opening the blockages in the arteries and/or restoring blood flow to the parts of the leg that aren’t receiving enough blood. Treatment for PAD is provided by a Vascular Specialist that is trained in either minimally invasive revascularization therapy or bypass surgery.
If you suspect that you have peripheral artery disease but haven't received a formal diagnosis, you can review your symptoms and risk factors here.
Minimally invasive revascularization is the recommended treatment for most people with PAD. Learn more about how it works and why we provide it.
We provide more detail on PAD treatment options so you can get a better idea of what treatment makes the most sense for you.
"Dr. Fritts gave me all the time I needed to understand & feel comfortable with the procedure. I am extremely grateful for his caring, gentle and highly competent care in a situation that has felt frightening and anonymous. He has a healer’s way about him. Highest recommendation."
-- Rod in Dallas, TX
Peripheral Artery Disease Treatment in Dallas, TX
Dr. Aaron Fritts, MD
Interventional & Vascular Specialist
Dr. Aaron Fritts is a board-certified Vascular & Interventional Radiologist that specializes in minimally invasive peripheral artery disease (PAD) treatment. Dr. Fritts is well-versed in vascular conditions, and has found passion in providing minimally invasive treatment for individuals suffering from PAD. He was recently selected as a SuperDoctors Rising Star and has been voted one of D-Magazine's best doctors in Dallas.
Living With Peripheral Artery Disease (PAD)
Peripheral artery disease (PAD) is a chronic cardiovascular condition in which atherosclerotic plaque builds up in the major arteries of the limbs, usually in the legs. These plaques can eventually develop into severe blockages that prevent blood from getting to parts of the leg that need it.
In its early stages, PAD can be completely asymptomatic for several years. As the disease progresses, you may begin to notice a cramping pain in your legs after walking long distances or during strenuous exercise (claudication). As more arteries in your legs are affected by PAD, your tolerance for exercise may decrease further, and in the more severe cases, you may develop open sores on your feet or ankles.
The end-stage of PAD is a serious condition called critical limb ischemia, which is characterized by open wounds, ulceration, gangrene, or persistent leg pain even when at rest. Critical limb ischemia is a very severe condition, and you should see a vascular specialist as soon as possible if you're living with these symptoms.
When we talk about PAD, we tend to talk about above-the-knee disease and below-the-knee disease. As the name suggests, above-the-knee PAD affects the major arteries above the knee and is usually felt in the buttocks, hip or thigh. On the other hand, below-the-knee PAD affects the major arteries below the knee and is usually felt in the calves or the feet.
Leg Pain When Exercising (Claudication)
Cramping pain when exercising, also called claudication, is one of the most telling signs of peripheral artery disease. Claudication patterns include:
Pain when exercising - you may feel pain in your buttocks, hips, thighs, calves, or feet depending on where you have peripheral artery disease
Intermittent pain - your pain may come and go
Pain when at rest - when very severe, PAD can cause severe pain when sitting or lying down
PAD may also cause generalized leg discomfort, including symptoms like:
Cold feet caused by poor circulation
Aching or burning in the legs
Heaviness or weakness in the legs
Numbness or tingling
Sores on the Foot or Leg
When the tissues in the leg do not get enough blood, sores on the leg or the foot can develop or become very challenging to heal. In the most severe cases, PAD can cause large open wounds or gangrene.
Discolored patches of skin
Open sores, ulcers, or wounds on the leg or the foot
Gangrene - the tissue dies and the skin turns black
PAD Risk Factors
Smoking | smokers are 2 to 4 times as likely to develop PAD than non-smokers
Diabetes | diabetics are also 2 to 4 times as likely to develop PAD than non-diabetics, and tend to have more severe PAD indicated by a 5 times higher likelihood of requiring an amputation, and a 3 times higher likelihood of cardiovascular-related mortality
High Blood Pressure | high blood pressure is extremely common, and increases your risk of PAD by 1.3 to 2.2 times that of individuals with healthy blood pressure
Dyslipidemia | high counts of 'bad' cholesterol (LDL) and low levels of 'good' cholesterol (HDL) increase your risk of PAD
Older Age | your risk of peripheral artery disease increases as you age, especially after age 65
Race and Ethnicity | population studies have shown that African American and American Indian populations are more likely to develop PAD than Asian Americans, Hispanics, and non-Hispanic Whites
Family History of Cardiovascular Disease | cardiovascular disease may run in your family, increasing your risk of PAD
PAD Screening & Diagnosis
Even if you don't have any immediate symptoms, screening for PAD is recommended if:
You are over age 65
You have a history of diabetes or history of smoking and are over age 50
You have diabetes and and other PAD risk factors such as obesity or high blood pressure
If you are symptomatic and your Vascular Specialist suspects that you could have PAD, usually the first step is to measure your ankle-brachial index (ABI). ABI is a non-invasive measure that is used to assess how well blood is flowing in your legs by measuring the blood pressure in your ankles and comparing it the blood pressure in your arms. If your ABI indicates that you have PAD, your vascular specialist may order an ultrasound or an angiographic imaging study to evaluate the best path forward to treat your PAD.
IVC is a fully staffed medical imaging and treatment center in Dallas, TX that can help you confirm if you're living with PAD. Give us a call to book your consultation.
PAD Revascularization Treatment
Minimally invasive revascularization is an image-guided procedure in which blockages in the arteries are opened up, restoring blood flow to parts of the leg that need it. Once blood flow is restored, parts of the leg that were previously suffering from a lack of oyxgen-rich blood are provided with enough of it to heal. Revascularization can involve a number of different approaches and may take place over multiple staged procedures to ensure safety and achieve the best possible result. Revascularization may involve one or a combination of the following approaches:
Balloon Angioplasty | a balloon device is positioned along the length of the blockage and inflated, opening the blockage
Stenting | a tubular support device made out of a special metal or polymer is placed along the length of the blockage and left in the artery to help it stay open after the procedure
Atherectomy | a mechanical device is used to remove atherosclerosis from the artery, typically reserved for completely occluded arteries or particularly hard plaque that is unsafe to open with balloon angioplasty
Revascularization Procedure: the blocked artery is opened up with a minimally invasive balloon, stent, and/or atherectomy device that is guided to the blockage through the vascular system.
Revascularization is performed through one tiny puncture in the groin or the arm. Interventional radiologists have special training and a number of tools that allow them to access blockages and treat them without making any major incisions.
Revascularization is performed under the guidance of fluoroscopic imaging. This allows your Vascular Specialist to safely treat the artery blockages with minimal risk of side effects.
Comprehensive PAD Treatment
A skilled Vascular Specialist can successfully treat blockages above-the-knee and below-the-knee, providing your legs with the best opportunity to heal.
Heal Your Legs
Revascularization restores blood flow to parts of the leg that need it, allowing wounds to heal.
Revascularization is an effective treatment for patients with lifestyle limiting claudication.
Revascularization can help relieve fatigue, discomfort, cramping, and pain caused by insufficient blood flow.
Revascularization is the recommended treatment for patients with end-stage PAD to avoid amputation.
Advantages of Revascularization
Compare PAD Treatment Options
If you're able, frequent walking is an important part of improving exercise tolerance when you have PAD. Supervised exercise therapy has PAD patients walk for 30 to 60 minutes at least 3 times a week. Unfortunately, supervised exercise is typically not reimbursed by health insurance.
The medications that are available for PAD are intended to extend how long you're able to walk without experiencing claudication. On average, medications improve walking distance by about 25%, but have a number of side effects and do not do anything to address the blockages that cause PAD symptoms.
Surgical bypass routes blood flow around the blockages caused by PAD. This is done by connecting a new vessel from where sufficient flow is present to a section of the leg where it is absent. The new vessel may be a prosthetic or a major blood vessel from the patient or a donor.
Endarterectomy is the surgical removal of part of the inner lining of the artery. Endarcterectomy procedure might be performed to remove blockages in certain arteries when minimally invasive revascularization is not possible.
Minimally invasive revascularization does not require any major incisions. The procedure is done by an Interventional & Vascular Specialist using small tubes and wires.
Minimally Invasive Revascularization
Recommended when PAD symptoms do not improve with exercise program or medical therapy, or patient is at risk of amputation
May be prescribed as a first-line therapy to improve walking distance
May be recommended when minimally invasive revascularization is not possible and PAD affects certain arteries
Usually recommended When minimally invasive revascularization has failed or is not feasible
May be prescribed as a first-line therapy to improve walking distance
PAD is a serious limb-threatening condition that can end in amputation if left untreated. A vascular specialist can treat your PAD and help you keep your legs healthy with minimally invasive revascularization therapy.
Give us a call to book your consultation today! We look forward to your visit.
PAD Treatment Options
 Kullo (2016). Peripheral Artery Disease. New England Journal of Medicine, 374(9), 861–871.
 Criqui (2015). Epidemiology of Peripheral Artery Disease. Circulation Research, 116(9), 1509–1526.
 Baerlocher (2015). Meta-Analysis of Drug-Eluting Balloon Angioplasty and Drug-Eluting Stent Placement for Infrainguinal Peripheral Arterial Disease. Journal of Vascular and Interventional Radiology, 26(4), 459–473.e4.
 Gerhard-Herman (2017). 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary. Journal of the American College of Cardiology, 69(11), 1465–1508.
The Materials available on ivcmd.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients.
Relieve Your Pain
Heal Your Legs
Peripheral Artery Disease (PAD) Treatment
PAD is a serious condition that can end in amputation if left untreated.
A Vascular Specialist can treat your PAD and help you keep your legs healthy!