Peripheral Arterial Disease (PAD)

Peripheral arterial disease (PAD) occurs when arteries in the legs or feet become narrowed or blocked by plaque buildup, a process known as atherosclerosis. Reduced blood flow causes pain, fatigue, and poor wound healing, and in severe cases, can lead to ulcers, infections, or tissue loss.

At The Medical Group of New Jersey, our vascular surgeons specialize in the early detection and treatment of PAD through lifestyle modification, advanced imaging, and minimally invasive interventions that restore circulation and preserve limb health.

Symptom Onset & Initial Evaluation

Peripheral artery disease (PAD) develops gradually as plaque builds up in the arteries, reducing blood flow to the legs and feet. Early symptoms may be subtle and often go unnoticed until circulation becomes significantly impaired.

Common warning signs include:

• Leg pain or cramping while walking that improves with rest (known as intermittent claudication)
• Cold, pale, or discolored feet or toes
• Slow-healing or non-healing wounds on the legs, feet, or ankles
• Weak or absent pulses in the legs or feet
• Numbness, tingling, or loss of leg hair from poor circulation

During your evaluation, your vascular specialist will review your symptoms, medical history, and risk factors, including smoking, diabetes, high cholesterol, and hypertension. A focused circulation exam helps determine the severity of disease. Early recognition and testing are essential to prevent serious complications such as limb ischemia or amputation.

Diagnosis

Diagnosis of PAD relies on noninvasive vascular testing to measure blood flow and identify narrowed or blocked arteries.

• Ankle-Brachial Index (ABI): A simple, painless test comparing blood pressure in the arms and ankles to detect reduced circulation.
• Doppler or Duplex Ultrasound: Provides real-time imaging of arteries to assess blood flow and pinpoint blockages.
• CT or MR Angiography: Produces detailed images of the arteries, used for surgical or endovascular treatment planning.

Vascular testing is performed on-site for prompt diagnosis, personalized treatment planning, and seamless coordination among our vascular team.

Treatment

The primary goals of PAD treatment are to improve circulation, relieve symptoms, prevent amputation, and protect long-term cardiovascular health.

Medical & Lifestyle Management

For most patients, treatment begins with medical therapy and lifestyle changes to slow disease progression:

• Smoking cessation: The most important step to prevent worsening of PAD.
• Structured exercise therapy: Supervised walking programs improve endurance and encourage the growth of new blood vessels (collateral circulation).
• Medications: Antiplatelet drugs (aspirin, clopidogrel), cholesterol-lowering statins, and blood pressure control help optimize vascular health.

Procedural & Surgical Options

If symptoms persist or blood flow is severely reduced, minimally invasive or surgical procedures may be recommended:

• Angioplasty and Stenting: Open narrowed arteries using small balloons or stents to restore blood flow.
• Atherectomy: Removes plaque buildup from artery walls to improve circulation.
• Bypass Surgery: Creates a new pathway for blood flow using a vein or synthetic graft when blockages cannot be opened.

At The Medical Group of New Jersey, each treatment plan is individually tailored to the patient’s symptoms, anatomy, and overall health. We offer minimally invasive options when clinically appropriate to minimize post-procedure discomfort and downtime.¹

1. Tang, Qian-Hui, et al. “Comparison between Endovascular and Open Surgery for the Treatment of Peripheral Artery Diseases: A Meta-Analysis.” Annals of Vascular Surgery, vol. 62, Jan. 2020, pp. 484–495.

Ongoing Management & Long-Term Prevention

PAD is a chronic condition that requires ongoing care and monitoring to maintain circulation and prevent recurrence. Long-term management may include:

• Regular follow-up visits: ABI and ultrasound every 6–12 months to monitor blood flow and detect changes early.
• Foot and skin care: Check daily for wounds, color changes, or ulcers and seek medical attention for any non-healing sores.
• Medication adherence: Continue taking antiplatelet and statin medications as prescribed.
• Exercise maintenance: Regular walking or physical activity improves endurance and reduces the risk of new blockages.
• Risk factor management: Control diabetes, hypertension, and cholesterol through lifestyle and medical therapy.

Our vascular specialists collaborate with cardiology, wound care, and rehabilitation teams to provide comprehensive, long-term management that supports both limb health and overall cardiovascular wellness.