critical limb ischemia

What to Expect from Your PAD Medical Team

What to Expect from Your PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet. Medical Team

Have you noticed new or increased symptoms such as poor circulation, leg pain, cold legs and sores recently?

Too many people dismiss these important signs as mild irritations. Some also worry that physicians won’t take their concerns seriously or, worse, will recommend amputationTo surgically remove all or part of a limb (leg, foot or toe). It feels easier to not schedule a doctor appointment.

Early detection is important if you have peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PAD). Through tests such as an ankle-brachial indexThis is the ratio of the systolic blood pressure (SBP) measured at the ankle to that measured in the arm artery. It is sometimes also called the ankle-arm index. (ABI) and getting the right treatment, you can help stop the disease from getting worse. You might also save a toe or leg from amputation.¹⁷

Learning how a team of medical providers will work with you will also make you feel more comfortable going to appointments.

Keep your PAD medical appointments

If you’re experiencing new symptoms, your first step is to meet with your primary care physician (PCP). According to the Society for Vascular Surgery, “If you are older than 50, have diabetes(Diabetes mellitus) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both., are a smoker or overweight and have leg pain when you walk, it is a good sign to talk to your doctor.” Your PCP’s evaluation will help determine if you need to see a specialist.

Your PAD medical team probably will involve several providers. “Nurse practitioners or physicians will function as a navigator for patients to ensure they go to every appointment,” says Dr. Jason Mendivil, a podiatrist for Pulse Amputation Prevention Centers in El Paso, TX. “It’s important to see every healthcare professional that is recommended to you — from interventional radiologists to podiatrists to vascular surgeons.”

What to expect from a PAD specialist

During your checkup with a PCP, they will determine if you’re at risk for PAD by asking questions about your medical history. They may also perform or request an ABI test. With this test, your doctors can compare the blood pressure in an arteryArteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. of the ankle to the blood pressure in an artery of the arm.

If you need to see a PAD specialist, you may work with a team of clinical care coordinators, podiatrists and wound care specialists, vascular specialists and other healthcare professionals.

Podiatrist will perform a general physical examination of your feet, especially with diabetic patients. They will also treat and track the healing of open wounds.
Vascular specialists will examine the blood flow through your entire leg. “Once I get an entire good picture of the entire arteriesArteries are blood vessels that carry blood to your heart and other parts of your body. and circulation of both legs, then we make a decision of what is the best way to treat a patient,” says Dr. M. Laiq Raja, a cardiologist at Pulse Amputation Prevention Centers in El Paso, TX. Minimally invasiveIn minimally invasive surgery, surgeons use a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows you to recover faster and heal with less pain and scarring. endovascularThis means “inside blood vessels.” To perform endovascular procedures, surgeons use special technologies and instruments. These procedures require only a small incision or puncture in an artery or vein. procedures include angioplastyIn this minimally invasive procedure, a small, hollow tube (catheter) is threaded through a blood vessel to the affected artery. A small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow., stenting and/or atherectomyA minimally invasive procedure to open blocked arteries by using a device on the end of a catheter to remove atherosclerotic plaque (a deposit of fat and other substances that accumulate in the lining of the artery wall).. For more serious forms of PAD, doctors may recommend arterial bypass surgeryYour doctor will create a graft bypass using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around – or bypass – the blocked or narrowed artery..

Schedule an initial evaluation and keep ongoing medical appointments with your PAD medical team. That way you can have more treatment options and avoid amputation of a toe, foot or leg due to advanced PAD.

For more information

If you or a loved one needs help finding a doctor or getting a second opinion, use CSI’s Find a Doctor tool to help find a PAD expert near you.

What are Varicose Veins?

Have you been noticing little purple and blue veins suddenly appearing on your legs? You could have varicose veins. These veins are abnormal, swollen and twisted blood vessels. They are often surrounded by thin, red capillaries commonly known as spider veins.

Varicose veins are a type of peripheral vascular disease (PVD), a category of diseases that affect the flow of blood in your legs. Peripheral Vascular Diseases include:

Chronic venous insufficiency
Deep vein thrombosis (DVT)
Thrombophlebitis
Varicose Veins
Peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.)

Varicose Veins — Not Just a Cosmetic Inconvenience

Varicose veins are not only a cosmetic inconvenience; they can also be very painful.

“A lot of my patients that have varicose veins have to go home at the end of their workday, put their legs up on a couch, take some Tylenol^® or Advil^® and do these things to get the pressure off of their legs by elevating them,” says Vascular & Interventional Radiologist Dr. Kirk Minkus, at Southwest Cardiovascular Associates in Phoenix, Ariz.

The Similarities and Differences Between Varicose Veins and PAD

PAD and varicose veins have some similar symptoms, such as leg pain, heaviness, a warm feeling and aching in your legs. Other symptoms of PAD include:

Cold toes or feet
Dry, discolored skin
Pain while walking
Nighttime leg pain
Numbness
Wound that won’t heal
GangreneGangrene is dead tissue, caused by poor blood flow to part of your body. Gangrene can occur on the skin or in muscles or organs. Peripheral artery disease is a known cause of gangrene. or black tissue

Studies have shown that patients with varicose veins may be at increased risk for PAD. The American College of Cardiology notes that the association between varicose veins and PAD is not certain, but clinicians should still be aware of a possible connection. Your doctor will likely ask about your symptoms at your appointments and routinely check the pulse and blood pressure in your legs and feet.

Don’t assume you know whether your symptoms are the result of PAD or varicose veins. Find a doctor to get a proper diagnosis and treatment.

“If you have any of these venous-type symptoms, you need to get in touch with a vascular specialist like myself,” says Dr. Minkus. “We can discuss with you the treatments we have to be able to fix varicose veins issues and this tight, bloated, swollen, painful, achy, warm feeling in your legs that you experience every day.”

For More Information

Would you like to know more about varicose veins? Watch Dr. Minkus discuss this subject in “Varicose Veins Explained”, brought to you by Take A Stand Against AmputationTo surgically remove all or part of a limb (leg, foot or toe)^® and The Way To My Heart.

Don’t let your symptoms intensify. Use CSI’s Find a Doctor tool to talk to a PAD specialist today.

We’re Here to Stand Against Amputation with You

We’re Here to Stand Against AmputationTo surgically remove all or part of a limb (leg, foot or toe) 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 diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.).³

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 and put 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 diabetes(Diabetes mellitus) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.³
The risk for amputation is 10 times greater in patients who have both PAD and diabetes versus those who have PAD alone¹²
Critical limb ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (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 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, Assistant 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 invasiveIn minimally invasive surgery, surgeons use a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows you to recover faster and heal with less pain and scarring. 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 diseaseA disease that impairs the kidneys’ ability to filter waste products and extra water from the blood.

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.
If you have received 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.

For More Information

There are treatment options available for PAD. Using the Find a Doctor tool to locate a specialist today and talk to them about your options.

Two Kinds of PAD Pain and Two Ways to Fight It

Two Kinds of PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet. Pain and Two Ways to Fight It

How bad is my pain from peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PAD)? Am I at a higher risk for amputationTo surgically remove all or part of a limb (leg, foot or toe) based on the pain I’m feeling? Vascular Surgeon Dr. Anahita Dua, with Mass General Hospital in Boston, Mass., explains the differences between experiencing pain while walking and pain in the legs while resting. Dr. Dua provides what the pain means, what can be done and the seriousness of peripheral arteryArteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. disease.

Watch Dr. Dua in “The Two Types of Peripheral Artery Disease Explained,” as she clearly and helpfully breaks down the two different categories of PAD and provides clarity into the kinds of pain PAD patients experience.

PAD in Two Buckets

PAD affects more than 20 million people and has a higher prevalence than cancer, stroke and congestive heart failure.^41–43 Despite that, many people don’t know enough about this potentially life-threatening disease.

Dr. Dua explains that PAD can be grouped in two categories:

Intermittent claudication: If a person experiences pain while walking, and they do not have open wounds on their legs or feet that won’t heal, they likely have intermittent claudication. This kind of PAD can have a very negative effect on quality of life. Dr. Dua explains that walking is the best way for people with this type of PAD to improve leg health, fight the effects of peripheral artery disease, and improve heart and overall health. She recommends that you push through and keep walking, even if you’re experiencing pain. The ultimate result will be an improved quality of life.
Critical Limb IschemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (CLI): This type of peripheral artery disease is as serious as it sounds. You may have wounds on your feet or legs that won’t heal, and may experience intense, burning, nighttime pain in your legs when they are at rest. If the pain is there when you’re walking and doesn’t go away even when you’re resting, you could have CLI. People with CLI are at risk of amputation. These individuals need to see a specialist who could prescribe intervention.

Regardless of which kind of PAD you have, see a PAD specialist. It’s important to have the right diagnosis so your doctor can develop and prescribe a treatment plan that is right for you.

For More Information

Detection and treatment of PAD is important. You can better understand the different types and symptoms of PAD. Watch Dr. Anahita Dua, Vascular Surgeon with Mass General Hospital in Boston, Massachusetts, in “The Two Types of Peripheral Artery Disease Explained” brought to you by Take A Stand Against Amputation^® and The Way To My Heart, for more details about the two categories of PAD.

Use CSI’s Find a Doctor tool so you can consult with a healthcare professional immediately if you think you might be at risk for PAD.

The Symptoms and Risks Factors of PAD

The Symptoms and Risks Factors of PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.

Would you recognize the symptoms of peripheral arterial disease (PAD) even if you were experiencing them? Sometimes the signs of pain in your legs and feet are so gradual they’re easy to ignore.

But PAD can lead to amputationTo surgically remove all or part of a limb (leg, foot or toe) if left untreated! Dr. Kirk Minkus, Vascular & Interventional Radiologist at Southwest Cardiovascular Associates in Phoenix, Arizona, warns about the consequences of missing the signs of PAD.

Watch Dr. Minkus in the video “Peripheral Artery Disease Symptoms and Risk Factors,” brought to you by Take A Stand Against Amputation^® and The Way To My Heart to learn more about this deadly disease.

Signs of Serious Health Problems

According to Dr. Minkus, “PAD is an affliction that affects the legs and can seriously restrict the amount of arterial blood flow that moves from your heart down to your toes and mainly, by way of the arterial vessels of your pelvis, your legs and your feet.”

PAD presents in a range of general symptoms, including:

Pain while walking
Limitation to how far you can walk
Pain and cramping in the calves or the legs
Discoloration of the feet and toes
Numbness in your feet or toes
Tingling in the legs or feet
Hair loss on the legs
Wounds that won’t heal
GangreneGangrene is dead tissue, caused by poor blood flow to part of your body. Gangrene can occur on the skin or in muscles or organs. Peripheral artery disease is a known cause of gangrene.

Unfortunately, many people do not realize they have a more serious health problem and dismiss the symptoms as the effects of getting older or as part of another condition.

For More Information

Do you want to discuss what you’ve learned about PAD with a healthcare professional? Use CSI’s Find a Doctor tool to talk to a PAD specialist today and prevent even the possibility of amputation.

Reducing Health Disparities: Black Americans and PAD

Reducing Health Disparities: Black Americans and PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.

Peripheral arterial disease (PAD) is more common in Black Americans than any other racial or ethnic group.⁶³ Black Americans are also twice as likely to get an amputationTo surgically remove all or part of a limb (leg, foot or toe) than White Americans due to PAD.⁴⁷

Why do these health disparities exist? And what can be done to reduce the possibility of amputations for Black Americans who have PAD?

Black Americans at Higher Risk for PAD

The risk of PAD varies between races, sexes, ages, smokers and people with diabetes(Diabetes mellitus) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.. The risk of PAD is about 30% for Black men and 28% for Black women, according to a recent study. In comparison, White Americans and Hispanics have a 20% chance to develop PAD.⁶³

The higher risk for PAD may be due to the prevalence of a number of conditions. For example, Black Americans are more likely to have anemia, high blood pressure and diabetes than White Americans.⁴⁷Diabetes is especially a problem for Black Americans due to biological risk factors including a combination of body mass index, waist measurement, fasting glucose levels, lipids, blood pressure and lung function, says the National Institutes of Health.

Let’s Not Accept PAD-related Amputations as Inevitable

Unfortunately, amputations as a treatment for PAD have been too normalized within the Black American community:

Black Americans are approximately twice as like to be amputatedTo have had all or part of a limb (leg, foot or toe) surgically removed. as White Americans⁴⁷
Black Americans have a far greater number of annual amputations⁴⁸

This data suggests that Black Americans have less access to care, are admitted to the hospital when sicker and are more likely to be treated at an Emergency Department.⁴⁷ Additionally, many patients and family members accept amputation as a treatment option from doctors who may not be PAD specialists and/or do not have limb salvage programs.

Amputation should be a last treatment option after exploring other minimally invasive approaches and arterial bypass surgery. Early diagnosis is also important so that PAD can be treated before it even becomes limb and life-threatening. Most physicians will diagnose PAD with a simple non-invasive ankle-brachial index (ABI). This screening test is one of the best ways to determine if a person has PAD and its level of severity.²³ Not surprisingly due to the higher risk of PAD, African Americans are two times more likely to screen positive for PAD than non-Hispanic whites based on data from the American Heart Association.

Because so many PAD and diabetes-related amputations are believed to be preventable, the American Diabetes Association is working to address this disparity in care and has included The Right to Avoid Preventable Amputations in their Health Equity Bill of Rights campaign that launched in 2020.

For More Information

It’s important for patients and loved ones to question if there are alternatives to amputation. Do your research! Don’t put your mobility and potentially your life at risk. Get a second opinion from a PAD specialist before agreeing to an amputation.

Learn about the treatment options available by using CSI’s Find a Doctor tool. Let’s all work together to reduce the PAD health disparities for Black Americans and the number of unnecessary amputations.

Partner With Your Doctor for PAD Treatment Options

Partner With Your Doctor for PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet. Treatment Options

You’ve suspected for a while that your pain is more than just getting older. Wounds won’t heal. Your skin’s discolored. Maybe you’re experiencing numbness or even burning in your legs and feet.

You might have peripheral arterial disease (PAD). This serious condition can lead to amputationTo surgically remove all or part of a limb (leg, foot or toe) or worse, if left untreated. Fortunately, there are a variety of treatment options available for PAD — from less invasive to more invasive. It’s important to have your doctor or specialist provide a diagnosis early.

Don’t hesitate and suffer with the symptoms in silence. Talk to and partner with your doctor to explore all available treatment options.

The PAD Spectrum of Care

Your doctor or PAD specialist will consider your symptoms comprehensively, evaluate your ankle-brachial indexThis is the ratio of the systolic blood pressure (SBP) measured at the ankle to that measured in the arm artery. It is sometimes also called the ankle-arm index. (ABI) results and your overall health. Then they will determine possible treatment strategies. If you receive a PAD diagnosis, your treatment plan may include one or more of the following approaches:

Non-surgical Treatments

The least-invasive method for treating PAD is through lifestyle modifications.³⁴ These include stopping smoking, managing your diet and exercising regularly.
In addition, your doctor may prescribe a supervised exercise therapy plan with a healthcare provider before considering medical procedures.
Your doctor may also prescribe medications to supplement lifestyle changes.⁸ Medicine can help lower high cholesterol and high blood pressure, prevent formation of blood clots and increase mobility while decreasing pain during walks.

Minimally InvasiveIn minimally invasive surgery, surgeons use a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows you to recover faster and heal with less pain and scarring. Treatments

For more advance cases of PAD, your healthcare provider may recommend minimally invasive treatment options²⁰ that are less complicated and safer than open surgery.

AngioplastyIn this minimally invasive procedure, a small, hollow tube (catheter) is threaded through a blood vessel to the affected artery. A small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow., stenting and atherectomyA minimally invasive procedure to open blocked arteries by using a device on the end of a catheter to remove atherosclerotic plaque (a deposit of fat and other substances that accumulate in the lining of the artery wall). are endovascularThis means “inside blood vessels.” To perform endovascular procedures, surgeons use special technologies and instruments. These procedures require only a small incision or puncture in an artery or vein. procedures where small catheters are inserted into an arteryArteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. and maneuvered to the area of blockage where treatment then occurs. Doctors now perform these procedures more commonly than bypass surgery(Arterial bypass surgery) Your doctor will create a graft bypass using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around – or bypass – the blocked or narrowed artery. for PAD.³²
- In angioplasties, doctors insert a small balloon that inflates to reopen an artery.
- During an atherectomy, a physician removes plaque buildup in arteriesArteries are blood vessels that carry blood to your heart and other parts of your body. using a catheter.
- Both procedures may be followed by placement of stents to keep the artery open.

Invasive Procedures

Arterial bypass surgeryYour doctor will create a graft bypass using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around – or bypass – the blocked or narrowed artery. is a technique in which the surgeon uses a blood vessel or synthetic vessel to create a new path around a blocked artery. As with minimally invasive treatments, doctors can perform an arterial bypass even if your PAD has developed into critical limb ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (CLI)¹⁶ — the worst form of PAD.⁵
Amputation — the removal of a leg, foot or toe — should be the last option after all other forms of treatment are considered.

See the entire treatment spectrum below. You can use it as a reference when discussing treatment options with your doctor.

PAD Treatment Options

For More Information

Discuss your symptoms with your doctor or PAD specialist to determine if you have peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.. Then determine the best treatment plan for you. There is hope!

To get a second opinion on your PAD diagnosis, please use CSI’s Find a Doctor tool to locate a PAD specialist near you.

PAD Treatment Evolution Helps Stop the Disease from Getting Worse

PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet. Treatment Evolution Helps Stop the Disease from Getting Worse

More than 20 million Americans have peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (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 amputationTo surgically remove all or part of a limb (leg, foot or toe).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 arteriesArteries are blood vessels that carry blood to your heart and other parts of your body. 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(Diabetes mellitus) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both., quitting smoking, eating healthier, being more physically active, and managing cholesterol and high blood pressure may help treat early-stage PAD.
Minimally invasiveIn minimally invasive surgery, surgeons use a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows you to recover faster and heal with less pain and scarring. procedures: These procedures are safer and provide faster recovery and healing with less pain and scarring. Your doctor may discuss angioplastyIn this minimally invasive procedure, a small, hollow tube (catheter) is threaded through a blood vessel to the affected artery. A small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow. or atherectomyA minimally invasive procedure to open blocked arteries by using a device on the end of a catheter to remove atherosclerotic plaque (a deposit of fat and other substances that accumulate in the lining of the artery wall). procedures to help open blocked arteries.
Arterial bypass surgeryYour doctor will create a graft bypass using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around – or bypass – the blocked or narrowed artery.: While minimally invasive procedures are performed now more often for PAD treatment,³² doctors sometimes recommend bypass surgery(Arterial bypass surgery) Your doctor will create a graft bypass using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around – or bypass – the blocked or narrowed artery. to treat critical limb ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (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

If you’re 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 diseaseA disease that impairs the kidneys’ ability to filter waste products and extra water from the blood. (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 diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.)?

PAD occurs when plaque, like calcium, builds up along blood vessel walls, narrowing the arteriesArteries are blood vessels that carry blood to your heart and other parts of your body. 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 ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (CLI).⁴

Chronic kidney disease also can lead to an increased risk of PAD-related amputationTo surgically remove all or part of a limb (leg, foot or toe), 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

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 gangreneGangrene is dead tissue, caused by poor blood flow to part of your body. Gangrene can occur on the skin or in muscles or organs. Peripheral artery disease is a known cause of 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 diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.).

Gangrene is often a sign of critical limb ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (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 arteriesArteries are blood vessels that carry blood to your heart and other parts of your body. 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 amputationTo surgically remove all or part of a limb (leg, foot or toe) 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.