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Gangrene — A Dangerous Sign of PAD

Gangrene is a symptom of the worst form of PAD called critical limb ischemia

Gangrene — A Dangerous Sign of PAD

Do you or a loved one have blackened areas or ulcers on your feet or toes? These are not just effects of old age — and they should not be ignored. In fact, this could be a sign you have gangrene.

Gangrene is the localized death of body tissue, due to a loss of blood supply. This infection can be a serious complication of peripheral artery disease (PAD).

Gangrene is often a sign of critical limb ischemia (CLI), a severe form of PAD. Talk to a doctor now if you suspect you have this limb- and life-threatening problem.

Symptoms of Gangrene

Gangrene is caused when you have restricted blood flow due to infection, injury or a chronic disease. Tissues will die from a lack of oxygen. CLI may be the culprit because it causes plaque buildup in your arteries and a reduction in blood circulation to the legs and feet. Without that circulation, the legs or feet are losing oxygen.

Symptoms of gangrene you should know about include:¹⁹

Dry and shriveled skin
Color changes – from blue to black
Skin that feels cold and numb
A clear line between the healthy and damaged skin
A foul-smelling discharge from a leaking sore
Severe pain near the affected part of the leg, foot or toe

Don’t Risk Amputation

Patients with CLI that goes untreated are at risk for amputation due to gangrenous tissue. Even worse, CLI can put your life at risk.⁴

The amputation rate for CLI patients is estimated to be 25%.⁵ Fortunately, treatment may be able to lessen the amount of amputation that is necessary — or even prevent amputation altogether.

For More Information

Pay attention to changes in your body. Talk to your doctor as soon as possible if you see any signs of gangrene. Only a healthcare professional can diagnose gangrene.

Explore our website to learn more about all of the symptoms of PAD including gangrene, and use our Find a Doctor tool to locate a PAD specialist.

How to Exercise with PAD

How to Exercise with PAD

One in twenty Americans over the age of 50 have peripheral artery disease (PAD).⁸ With this condition, many people experience heavy and tired legs. So how can you exercise with PAD safely to feel better?

The first step is to start slowly — but consistently — with a new routine. A good goal: Do aerobic activity 3 to 5 times a week and strength exercises 2 to 3 times a week. Keep reading to learn how you can improve your overall health and well-being.

Frequently Asked Questions about Exercising with PAD

Exercise helps people with PAD improve heart health and sleep patterns, while reducing blood pressure and excess weight. When kick-starting a healthier routine, check out these answers to some common questions.

Q: What are the best types of exercises for my foot and leg pain?

A: Walking is a low-impact exercise that elevates your heart rate and can improve your mobility. Have a goal of walking up to five days a week. And if walking outside doesn’t feel like a good fit, try the treadmill, a stationary bike, beginner yoga poses or swimming.

Q: How do I exercise if it feels painful?

A: Exercising will cause typical muscle aches and pains at first. Start slowly, walking for 10 to 15 minutes. Then walk a little longer each week. Also, drink lots of fluids before, during and after exercising. Staying hydrated may reduce pain. However, talk to your doctor if you’re feeling pain that’s above and beyond typical soreness.

Q: How do I take care of my feet and legs before and after exercise?

A: Remember to warm up, stretching your calf and thigh muscles for 10–15 minutes, before you start exercise. Wear proper footwear and thick socks that provide the support you need.

To check out more exercise options, read “Being Active When You Have Peripheral Arterial Disease,” a helpful three-page guide from the American College of Sports Medicine on aerobic training, strength training and other forms of physical activity.

For More Information

It’s time to get moving! Committing to more physical activity is good advice for anyone. Ask your healthcare professional today about the best way to get started with an exercise program.

Visit our website to learn more about PAD, and use our Find a Doctor tool to locate a PAD specialist.

Guidance sourced from the American College of Sports Medicine

PAD Treatment Options

You can find PAD options that will help.

PAD Treatment Options

More than 20 million Americans have peripheral artery disease (PAD).¹ However, while so many Americans are affected by PAD, too few are receiving treatment.

PAD is a complex disease. Early detection and getting treatment could help stop the disease from getting worse – and potentially save a toe or leg from amputation.¹⁷

The good news is that there are more treatment options available now for PAD, according to Dr. Chris Boyes, vascular surgeon at Coastal Vein and Vascular Specialists in Palm Beach Gardens, FL.

“Previously, if people had severe disease in the small arteries below the knee, we typically took X-rays and said, ‘okay, we’re done,’ ” says Dr. Boyes. “Then we sent them to the wound care center, crossed our fingers and hoped that the wound healed. If the wound didn’t heal, then we would do an amputation.”

Current PAD treatment options

While patients 5 to 10 years ago didn’t have many options for therapy, now there’s a range of possible treatments that avoid amputation, according to Dr. Boyes.

Lifestyle modifications: Managing diabetes, quitting smoking, eating healthier, being more physically active, and managing cholesterol and high blood pressure may help treat early-stage PAD.
Minimally invasive procedures: These procedures are safer and provide faster recovery and healing with less pain and scarring. Your doctor may discuss angioplasty or atherectomy procedures to help open blocked arteries.
Arterial bypass surgery: While physicians approve minimally invasive procedures now more often³²for PAD treatment, they sometimes recommend bypass surgery to treat critical limb ischemia (CLI) ― the worst form of PAD.⁵

The effects of PAD can lead to other severe health problems. If you’re concerned about new symptoms or ones that aren’t getting better, don’t wait to explore your treatment options. There is hope!

For more information

Are you experiencing nighttime leg pain, pain while walking, numbness or burning sensations, or wounds that won’t heal? Talk to your doctor about your symptoms so you can get help as soon as possible. To find a doctor or get a second opinion, use CSI’s Find a Doctor tool to help explore the variety of PAD treatment options available.

Learn the Connections Between Kidney Disease and PAD

Chronic kidney disease (CKD) is a difficult but manageable condition with proper treatment.

But did you know it is connected to other health risks, such as peripheral artery disease (PAD)?

PAD occurs when plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet. The disease is widespread and can be life threatening.¹

If you have CKD, it’s important to ask your doctor about PAD. The disease is an often overlooked and under-diagnosed condition in patients with CKD.⁴⁶ Researchers estimate that up to 37% of people with CKD also have PAD.⁴⁶

Both diseases are connected to your body’s blood flow. Kidneys help regulate your blood in several ways, and they are sensitive to decreased blood flow.

When you have CKD, your kidneys don’t filter your blood as well as they should, and the levels of minerals, such as calcium, can become unbalanced.³⁹

PAD, which can include calcium, occurs when blood does not flow well to your legs and feet due to the narrowing of your arteries. Calcium build up in your arteries can put you at risk of developing the worst form of PAD — critical limb ischemia (CLI).⁴

Chronic kidney disease also can lead to an increased risk of PAD-related amputation, which can have a significant impact on your quality of life.²⁵ It also can put your life at risk, and kidney disease can increase that risk.²

There is good news. Like CKD, there are treatment options for PAD. So, if you’ve been diagnosed with kidney disease and you are concerned about PAD, talk with your nephrologist or other health care professional. Only a doctor can diagnose you with PAD and determine the appropriate treatment.

Take our symptom quiz to help guide the conversation about your treatment options.

Symptoms of PAD
Cold toes or feet
Dry, discolored skin
Pain while walking
Nighttime leg pain
Painful, heavy legs
Numbness or burning sensations
Wounds that won’t heal

Don’t Ignore the Signs. Early Detection Can Make a Difference in PAD.

As you get older, you might assume that some of the aches and pains you’re experiencing are just a normal part of aging.

Maybe you have frequent discomfort in your legs and feet, and you figure it’s just poor circulation. But poor circulation can be an actual disease — a serious condition called peripheral artery disease (PAD).

PAD can occur when blood flow in your legs and feet is restricted by narrowed arteries due to plaque (e.g., calcium) build-up. PAD is a serious disease — left untreated, it can lead to amputation.⁹

Of course, your body will change the older you get. But you shouldn’t dismiss things like pain while walking or one foot being colder than the other as a normal part of aging.

One in 20 Americans over the age of 50 has PAD,⁵⁰ and many people living with the disease don’t show any symptoms. You can learn more about the symptoms of PAD and the risk factors on the other pages of this website.

Only a doctor can diagnose you with PAD, and it’s important to talk to a health care professional about how you feel. A simple screening test called an ankle-brachial index (ABI) can help a doctor determine if you’re at risk.

There is good news: If you do have PAD, early detection and treatment could help stop the disease from getting worse. Many treatment options are available. They could reduce pain, improve walking ability and enhance your quality of life.

In some cases, your doctor may recommend diet changes, exercise and/or medications. If that is unsuccessful, your doctor may also recommend a minimally invasive treatment or procedure.⁵¹

More good news: Treatment options for PAD are constantly advancing, and today’s techniques are different than they were just five years ago.⁵¹ So don’t wait to call your doctor to talk about PAD. Early detection is important.

If you want to see a PAD specialist, use our Find a Doctor tool to locate one near you.

It’s Okay to Ask for a Second Opinion

Have a doctor check your feet and ask for a second opinion to get the best treatment possible

It’s Okay to Ask for a Second Opinion

Peripheral artery disease (PAD) has many treatment options, including long-term lifestyle changes and medications.

However, if you have advanced PAD, these treatments might not be enough. Your doctor may recommend bypass surgery or amputation, a common treatment for the most severe stage of PAD.³

This is an important decision. There are more than 160,000 PAD-related amputations annually performed in the U.S.,³ and having an amputation can put your life at risk.³

So how do you know if other treatment options are available for you?

Get a second opinion. Talk with a doctor who is a PAD specialist or is a part of a limb salvage program.

It’s OK to think about whether another doctor may suggest different treatment options. As with any big decision, you want to make sure you’ve gathered as much information as possible in order to make the best decisions about your health.

Keep in mind, not all health care professionals are PAD specialists — and not all PAD specialists use the same treatment techniques. Treatment options for PAD are constantly advancing, and today’s options are very different than they were just five years ago.²⁰

Some questions you might want to consider asking your doctor:

Does your clinic/hospital have a limb salvage program?
What treatment options do I have other than amputation?
What benefits do these options offer compared to amputation?

It’s up to you to take control of your health. If amputation has been recommended for you, get a second opinion that could help guide your decisions. Medical treatments to help restore blood flow to your legs may be able to help save legs and feet. In many patients, these treatments have been shown to offer advantages when compared to amputation.¹⁷

Only a doctor can determine the most appropriate treatment options for your condition, but it’s important to explore your options. Find a PAD specialist near you and ask for a second opinion about your treatment.

Stop Smoking and Improve Your PAD Outlook

Stop smoking - By breaking the cigarette habit, you can improve your PAD outlook

Stop Smoking and Improve Your PAD Outlook

You’ve likely heard it many times: Smoking is bad for your health. But if you have peripheral artery disease (PAD), smoking cigarettes could have a stronger effect on your health than you realize.

Smoking is a significant risk factor for PAD.³⁷ The lives of patients with PAD who also have cardiovascular problems could be at greater risk.²⁸

People who smoke are also at risk for developing plaque in their arteries (atherosclerosis)¹⁹ — a leading cause of PAD, heart attack and stroke.²¹ PAD results from narrowed arteries in the legs, limiting blood flow to the legs and feet. PAD can lead to a range of symptoms including aches, numbness and burning sensations in your legs and/or feet.

Without early detection and treatment, PAD can advance. The worst form of PAD is, critical limb ischemia (CLI). People with CLI commonly have pain while walking. They may have open wounds on their feet or legs that won’t heal. Many people with CLI are at significant risk for amputation if they don’t seek treatment. Things can even get worse from there — CLI has been linked to putting a person’s life at risk.⁴

Smoking and aging are risk factors

Plus, aging plays a role in raising a smoker’s risk of PAD. The older a smoker is, the higher the risk for PAD.¹³

There is good news: There are treatment options for PAD. If you are a smoker, talk to your health care professional about your risk level for PAD. You can talk about options to help you stop smoking. If the doctor does diagnose PAD, you can discuss treatment options.

Don’t delay — talk to your doctor now. Use our Find a Doctor tool to locate a PAD specialist near you who is experienced using Cardiovascular Systems, Inc., devices to treat PAD.

We’re Here to Stand Against Amputation with You

We’re Here to Stand Against Amputation with You

A lesser known health condition is making a big impact in the U.S. Every year, about 160,000 Americans undergo an amputation due to peripheral artery disease (PAD).

That is a significant number for one health condition, and it’s staggering considering that it represents more amputations than all U.S. war-related amputations since the Civil War.

PAD is a common and often underdiagnosed circulatory disease where blood flow to the legs and feet is restricted by the narrowing of blood vessels due to plaque buildup. Left untreated, PAD can lead to amputation. This puts you or a loved one’s quality of life and long-term health at serious risk.

Amputations result from a variety of factors, including underlying conditions, late-stage diagnosis and healthcare disparities.

73,000 amputations per year are patients with diabetes¹²
The risk for amputation is 10 times greater in patients who have both PAD and diabetes versus those who have PAD alone¹²
Critical limb ischemia (CLI) — the advanced form of PAD — carries a high risk of lower limb amputation estimated in 10% to 40% of patients⁶⁰
African Americans are up to 4 times more likely to have an amputation due to complications of diabetes and PAD than Caucasian Americans⁶¹

How to get the best care for PAD

Many people dismiss early PAD symptoms, like pain while walking or cold feet. Instead of talking with a health care professional, they may think these changes are just a normal part of getting older.

But it’s crucial to take these symptoms seriously and to schedule regular medical appointments and have open discussions with your doctor, according to Dr. Jihad Mustapha, Associate Professor for Medicine at Michigan State University.

“If you have critical limb ischemia (the most severe form of PAD), your chance of dying is higher than colon, breast or prostate cancer,” he says. “Tell your doctor exactly what you’re feeling. With early detection of PAD, there are more treatment options available. Your physician may be able to recommend lifestyle changes or a minimally invasive procedure.”

Are you at risk for PAD?

Over 50 years old
A current or former smoker
Have diabetes
Struggle with high blood pressure or cholesterol
Suffer from kidney disease

Reduce the risk of amputation

There are ways to reduce the possibility of amputation in addition to making lifestyle changes.

If you exhibit risk factors, talk to your doctor about PAD.
After a PAD diagnosis, keep in-office or telehealth appointments to avoid more serious surgical interventions.
If a doctor recommends amputation, you can ask for a second opinion. Use our Find a Doctor tool to locate a PAD specialist.

Consider a Doctor’s Reputation When Looking for a Second Opinion Before Amputation

Consider a Doctor’s Reputation When Looking for a Second Opinion Before Amputation

There are 160,000 amputations related to peripheral artery disease (PAD) performed every year in the U.S.³ Many of these patients might have avoided such a drastic procedure with a strong clinical support team.

Gain Insight Before Making a Decision

In this video, Kym McNicholas, founder of The Way to My Heart (a non-profit that directly supports patients in their effort to get high-quality care for PAD), and Dr. John Phillips, an interventional cardiologist at OhioHealth Physician Group in Columbus, OH, discuss exploring every possibility before accepting an amputation:

Don’t just follow doctor’s orders when faced with amputation. Actively seek a second opinion if your doctor isn’t a PAD specialist or doesn’t offer a limb salvage program.³³

Unfortunately, amputation as a treatment is often accepted at face value.

“Patients that have been raised to trust their doctors ― no matter what ― will listen to whatever their doctor says,” says Dr. Phillips. “And if the doctor says it’s an amputation, it’s an amputation.”

People suffering from PAD are also in extreme pain and discomfort. “So many patients get to the point where the pain is so excruciating that they can’t imagine that anything, any procedure, could take away that pain except for just simply cutting it off,” says McNicholas.

Cutting off your limb isn’t always the only option. There are many treatment options available, including lifestyle changes, medical management, minimally invasive procedures and arterial bypass surgery. In addition to getting a second opinion, leverage the services offered by The Way to My Heart, talk to friends, family members and even Facebook groups or chatrooms to gain insight into other PAD patients’ experiences before making a potentially life-changing decision.

For More Information

You must be your biggest advocate as a patient to find the best doctor for you. Watch the full video to learn more about getting a second opinion before moving forward with an amputation. You can also learn more about PAD and find a PAD specialist near you by using CSI’s Find a Doctor tool.

ARC Act Proposed to Prevent Amputations

The ARC Act is a bipartison effort to prevent PAD-related amputations

The ARC Act — A Bipartisan Effort to Prevent PAD-Related Amputations

Too many of us know people in our communities who’ve had amputations for conditions such as peripheral artery disease (PAD). The procedure is all-too common, especially in minority populations.⁴⁷ But there is hope — with screening and treatment options that can help prevent amputations. Congressional leaders are also trying to make these options accessible to more people.

A proposed bill in the U.S. House of Representatives, called the Amputation Reduction and Compassion (ARC) Act, would boost coverage of services to help Americans avoid losing their toes, feet and legs due to PAD.

What is the ARC Act?

An estimated 20 million Americans have PAD^41–43. Unfortunately, many are unaware of the serious risks posed by the disease. Regular screenings are uncommon, resulting in more than 160,000 PAD-related amputations every year.⁴⁷.

Racial and ethnic minorities are especially at risk. Black Americans and Native Americans are approximately two times more likely than White Americans to experience a nontraumatic amputation due to PAD. Hispanics are up to 50% more likely to have an amputation.^47,62.

But things would change if the ARC Act becomes a law. It would mandate:

Medicare, Medicaid and group health insurance plans to fully cover costs for PAD screening tests for at-risk beneficiaries
Arterial testing prior to non-traumatic amputations to determine if there are alternative intervention options to amputation
Funding for a PAD educational initiative for healthcare professionals and the public about methods to reduce amputations and at-risk populations

With this important legislation, the hope is to reduce the number of amputations that result from advanced PAD.

The ARC Act Legislative Process

The ARC Act bill is sponsored by Representative Donald M. Payne, Jr. (D-NJ) and originally co-sponsored by Representatives Jeff Van Drew (R-NJ), Ruben Gallego (D-AZ), Bobby L. Rush (D-IL), Mark Takano (D-CA), Raul M. Grijalva (D-AZ), Katie Porter (D-CA), Darren Soto (D-FL), G.K. Butterfield (D-NC), Ayanna Pressley (D-MA) and Albio Sires (D-NJ).

Payne, Jr. has long supported bipartisan efforts to reduce PAD-related amputations. He co-founded the PAD Caucus in April 2019 with Rep. Gus Bilirakis (R-FL). Payne, Jr. hopes to raise awareness of PAD and include it in federal government healthcare priorities going forward.

“PAD is treatable, if we catch it early,” Payne, Jr. said in a statement. “Medicare and Medicaid treat our most vulnerable citizens. We need to allow these two critical programs to support medical professionals and patients and not cut critical funding that could cause Americans to lose their limbs.”

For More Information and How You Can Support the ARC Act

You can make a difference! Help move the ARC Act legislation forward by clicking here to ask your lawmaker to co-sponsor the ARC Act.

Learn more about the symptoms of PAD and explore available treatment options by finding a PAD specialist using the Find a Doctor tool.