What Doctors Diagnose and Treat 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.?

Are you worried that pain in your leg is getting worse? Or are you experiencing cold toes or feet? Sometimes you may even have numbness or burning sensations in your legs.

You may be experiencing symptoms of peripheral artery disease (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.).

It’s important to not assume these symptoms as part of the normal aging process because if not detected early, PAD could lead to amputationTo surgically remove all or part of a limb (leg, foot or toe). But what type of doctor or PAD specialist should you see for help?

Start with your primary care physician

See your primary care physician (PCP) if you’re experiencing any leg pain, wounds that won’t heal or dry, discolored skin. Before arriving at a PAD diagnosis, your PCP will initially consider your:

• Medical history. Expect questions about your history of coronary heart diseaseA disease in which plaque builds up inside the coronary arteries, which supply blood to your heart muscle., cardiovascular and cerebrovascular disease, diabetes(Diabetes mellitus) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both., hypertensionHypertension is a medical term for high blood pressure., cholesterol levels, previous surgical and interventional radiological procedures, chronic kidney diseaseA disease that impairs the kidneys’ ability to filter waste products and extra water from the blood. and more. Your PCP also will ask you about your smoking history.
• Family’s medical history. Do you have one or more members of your immediate family who have undergone surgical procedures on arteriesArteries are blood vessels that carry blood to your heart and other parts of your body. in the legs like balloon 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., stent or surgical bypass before the age of 65? Do you have a relative who has had a non-traumatic foot or lower leg amputation?
• Clinical examination. Your doctor may assess you for weak or absent arteryArteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. pulses, measure blood pressure with the 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) test, take blood, and check your skin and nails for poor wound healing and changes in color.

When to see a PAD specialist

For early-stage PAD, your doctor may recommend long-lasting lifestyle changes.³⁴ “You often can successfully treat peripheral artery disease by quitting tobacco, exercising and eating a healthy diet,” according to the Mayo Clinic. PCPs can also treat moderate cases with medication.

However, for more advanced cases of PAD, your PCP may recommend seeing a PAD specialist, such as:

• Interventional cardiologists or radiologists who perform 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 like angioplasty, 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). or stenting to restore blood flow.
• Vascular specialists who treat blood vessel diseases and can perform lower extremity 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 PAD. This bypass graft surgery in the leg removes a healthy blood vessel in the leg and grafts it above and below the blockage.
• Cardiologists who may be consulted in case of heart problems, such as congenital heart disease (CHD), chest pains and a heart attack, associated with PAD.

Don’t wait to talk to a doctor about your symptoms. Seeing a PCP and getting an early diagnosis can make a big difference in your health — and possibly save you from amputation.

For more information

Take CSI’s interactive Symptom Quiz if you’re concerned about PAD. The quiz offers a list of questions to help you talk with your PCP. You can also use our Find a Doctor tool to locate a PAD specialist near you.