What Comes Next: Peripheral Artery Disease
Making Sense of Your Diagnosis
Reviewed by the Columbia Vascular and Endovascular Faculty, December 2025
Being diagnosed with peripheral artery disease (PAD) can leave you with a lot of questions. You may be wondering how serious it is, what treatments are available, and how your daily life might change. PAD is one of the most common circulatory conditions, affecting millions of adults worldwide, and is highly treatable.
Our What Comes Next series is designed to answer common questions and help you feel more informed and supported as you take the next steps.
I’ve Been Diagnosed with Peripheral Artery Disease. How Serious Is It?
It depends on how much your blood flow is affected and whether you have symptoms. PAD occurs when arteries in your legs or other parts of your body become narrowed or blocked by plaque buildup (atherosclerosis). This reduces oxygen-rich blood flow to your muscles.
Mild PAD may cause no symptoms at all. More advanced cases can cause leg pain when walking (claudication); in severe cases, it can lead to wounds that don’t heal or even risk of limb loss (amputation) if blood flow becomes critically low.
PAD is also a sign that atherosclerosis may be present elsewhere in your body, increasing your risk for heart attack and stroke. That’s why early diagnosis and treatment are so important.
What Causes Peripheral Artery Disease?
The most common causes and risk factors include:
- Atherosclerosis (plaque buildup in the arteries)
- Smoking — the single greatest risk factor
- Diabetes and Obesity
- High cholesterol or high blood pressure
- Family history of vascular or heart disease
- Chronic Kidney Disease
- Age, especially over 60
These same factors can affect the heart and brain, which is why treating PAD also helps protect your overall cardiovascular health.
I Feel Fine. Should I Be Concerned?
Even if you don’t have symptoms now, it’s important to monitor your circulation and manage your risk factors. PAD often progresses silently.
When symptoms do occur, they can include:
- Leg pain, cramping, or fatigue during activity that improves with rest
- Numbness or weakness in the legs or feet
- Slow-healing sores or color changes in the skin
- Coldness in one leg compared to the other
If you notice these signs, talk with your doctor. Remember: early treatment can prevent more serious complications.
Will I Need a Procedure?
Not necessarily. Most people with PAD can start with non-surgical treatments, including:
- Lifestyle changes — especially quitting smoking, improving diet, and exercising regularly
- Medications to improve circulation, reduce blood pressure and cholesterol, and prevent blood clots
If symptoms remain severe or if you have wounds that won’t heal, we may recommend a minimally invasive procedure (such as angioplasty or stenting) or, in more advanced cases, a surgical bypass to restore blood flow.
What Are My Treatment Options?
Depending on your diagnosis, you may benefit from:
- Exercise therapy, like supervised walking programs that improve circulation
- Medications to manage blood pressure, cholesterol, and blood thinning
- Angioplasty or Stenting, a catheter-based procedure to open blocked arteries - a common minimally invasive treatment for PAD.
- Bypass surgery for rerouting blood around a blocked artery using a vein or graft in advanced stages of PAD
- Wound care and foot protection, if blood flow is severely reduced
Your specialist will help determine the best approach for your specific situation.
Can Medications Fix the Blockages?
No, but they can slow or stop progression, improve symptoms, and reduce your risk of heart attack and stroke. Lifestyle changes, especially quitting smoking, improving your diet, and regular walking, are just as critical as medication in managing PAD.
How Will I Know If It’s Getting Worse?
You should contact your doctor if you notice:
- Increasing leg pain when walking shorter distances
- Pain at rest, especially at night
- Wounds or ulcers that won’t heal
- Numbness, tingling, or color changes in your toes or feet
PAD is monitored using ankle-brachial index (ABI) tests, ultrasound, or CT/MR angiography to track blood flow and artery health.
Will I Feel Better After Treatment?
Yes, most patients experience reduced pain, increased walking ability, and improved quality of life once blood flow improves. You’ll likely regain confidence in being active again, and healing of sores or ulcers usually speeds up.
Will Treatment Help Me Live Longer?
Yes. Treating PAD helps more than just your legs; it helps your whole cardiovascular system function better. By improving circulation and controlling risk factors, PAD treatment can significantly lower your chances of heart attack, stroke, and amputation, and help you live a longer, healthier, and more active life.
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