Peripheral Artery

About Peripheral Artery Disease (PAD)

Peripheral Artery Disease (PAD), also referred to as Peripheral Disease, is a common condition where a build-up of fatty deposits in the leg arteries restricts blood supply to the leg muscles – this process is called atherosclerosis.


Many people with PAD have no symptoms. However, the classic symptom is leg pain when walking that stops with rest, known as “intermittent claudication”.

Often both legs are affected at the same time, although the pain may be worse in one leg.

The symptoms of PAD often develop slowly, over a long period of time. If symptoms develop quickly, or become worse within a short space of time, this could be a sign of a serious problem that might require immediate treatment.

Other symptoms of PAD can include:

  • hair loss on legs and feet
  • numbness or weakness in the legs
  • brittle, slow-growing toenails
  • ulcers (open sores) on feet and legs, which do not heal
  • changing skin colour on legs, such as turning pale or blue
  • shiny skin
  • in men, erectile dysfunction
  • the muscles in the legs shrinking (wasting)

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PAD is usually diagnosed through a physical examination by a GP, and by comparing the blood pressure in the arm and the ankle.
A difference between the two may indicate PAD and is called the ankle brachial pressure index (ABPI).

Furthermore, these findings are associated with peripheral disease:

  • decreased or absent pulses
  • muscle atrophy or wasting
  • noticeable blueness of the affected limb
  • decreased temperature (coolness) in affected limb when compared to the other
  • thickened nails
  • smooth or shiny skin and hair loss
  • Buerger’s test: checking for pallor when the affected limb is in an elevated position. The limb is then moved from elevated to sitting position and is checked for redness, which is called reactive hyperemia. Buerger’s test is an assessment of arterial sufficiency, which is the ability of the artery to supply oxygenated blood to the tissue that it goes to.

Additional hospital-based tests that may be carried out include:

  • an ultrasound scan – where sound waves are used to build up a picture of arteries in the leg. This can identify the possible location of the blockages or narrowed areas in the arteries
  • an angiogram – where a liquid called a contrast agent is injected into a vein in the arm. The agent shows up clearly on a CT scan or MRI scan and produces a detailed image of the arteries
  • in some cases the contrast agent may be injected directly into the arteries of the leg and X-rays may be used to produce the images.

Source: NHS