Plaque build-up in the arteries of the peripherals (arms, brain, legs), mainly the legs.

PAD is a chronic illness in which there is currently no cure but long-term management is possible.

• Leg Pain
• Cramping
• Tingling
• Numbness
• Cold Feet
• Less Leg Hair Growth
• Slow Nail Growth
• Non-healing foot/leg ulcers (Advanced Stage)
• Gangrene (Advanced Stage)

• Family History
• Obesity
• Smoking
• High Cholesterol
• Hypertension
• Age - over 50
• Pre-Diabetes, Diabetes

Plaque build-up in the arteries is triggered by a variety of factors. It could be environmental, genetic, or lifestyle. Plaque build-up is generally the body's inflammatory response to "bandaid" artery damage caused by hypertension, stress, diet, smoking, and/or diabetes. Advanced blood work can help get to the root cause.

PAD does not have a cure. But you can slow disease progression significantly by getting to the root cause of what's damaging your arteries, making critical lifestyle modifications, and timely treatment. Online research will reveal a 5-year mortality for PAD. Early diagnosis and newer interventional approaches have improved the prognosis. Patients are walking 20 years after diagnosis with the right treatment.

There are two classifications for PAD: Claudicant and Critical Limb Ischemia, which is advanced stage. If diagnosed in its early stages, PAD can be managed with Pharma, and Lifestyle modifications (Diet, Exercise, etc.). Walking is the best medicine in the early stages because your body may have the ability to re-route blood flow around blockages with a regimented walking program.  Advanced stages may require intervention using endovascular (minimally invasive tools and techniques) or invasive procedures such as bypass and amputation. Don't let your doctor brush off leg pain and cramping as old age, poor circulation or neuropathy.

Getting a referral to an interventional vascular specialist soonest is critical to begin taking steps to slow disease progression.

Discuss critical pharma, exercise, and diet, and supplement options that will make a big big difference.

Walking is critical to improving symptoms as your body grows collateral vessels to increase blood flow around artery narrowing with every step you take.

Walking a lot can help delay surgical treatment and increase the timespan between follow-up surgical interventions.

If caught early, most Interventional Vascular Specialists will tell you to walk until you experience what's called, "Lifestyle Limiting Claudication." Most patients early on can walk a short distance, stop for a few when legs tighten up, and can continue to walk a little more after a 90 second break.

Your Interventional Vascular Specialist will consider an Angiogram, a minimally invasive surgical treatment to improve blood flow when you can no longer maintain an active lifestyle because the pain and cramping is unbearable due to plaque has caused a narrowing and stiffness in your arteries.

Angiograms are typically are outpatient procedures performed under light sedation and take anywhere between one to three hours.

Doctors usually will start with a simple puncture in the groin area and follow with a wire to navigate the vessel. A balloon may follow to lightly push plaque aside but heavy plaque build-up may require what's called an "Atherectomy" device, which physically removes the plaque either with a blade, audiowaves, or laser (Rotational, Orbital, Directional, Audiowave, Laser).

If a doctor is highly skilled in new Interventional techniques for revascularizing arteries, (s)he will be less likely to suggest bypass or amputation.

This is a life & limb saving decision that should not be taken lightly.

There are three primary practices which treat Peripheral Artery Disease:

• Interventional Cardiologist
• Interventional Radiologist
• Vascular Surgeon

Some overlap in their treatment approach, others do not. Some are highly trained in newer minimally invasive procedures and others are heavily trained in invasive bypass & amputation. Upon referral, most general practitioners don't know the Vascular Specialist's approach for treatment.

You must research.

Different doctors have different limitations, whether it's standard protocols, monetary, exclusive vendor relationships for tools, or skillset that may impact your long-term prognosis.

Each one is likely to tell you that if they can't do it, no one else can either and their way is the best way. It may be true. It may not, even at the most prestigious hospitals and with doctors who have the highest pedigree.

But it's not worth taking the chance.

Ask questions about...

• their their standard approach, 
• go-to tools,  
• their threshold for revascularizing arteries in a minimally invasive way before giving up and choosing bypass or amputation,
• how do they minimize trauma to the vessel to ensure long-term patency, 
• whether they are highly trained in revascularizing small vessels below-the-knee, 
• and more specifically about their experience in revascularizing the plantar loop especially in Diabetic feet. 

Your life and limb depend on it.

Amputation should be a last resort ONLY if ALL minimally invasive treatment options are exhausted yet more than 200,000 PAD related limb amputations are performed every year.

Recent advances in techniques, tools, and approaches now make amputation rarely necessary with the right physician.

In fact, more than 80% of all P.A.D. related limb amputations are preventable with early appropriate diagnosis and treatment.

Ask your physician if he is considered a "CLI Fighter" by his peers who knows how to use wires and balloons clear into the pedal loop of the foot and can offer multiple approaches to tackle a blockage, including coming down from the groin AND coming up from the foot or calf.

If your doctors says bypass or amputation, ask for a second opinion elsewhere outside of the hospital.

EVERY Doctor has different tools, techniques, and approaches. ALWAYS seek multiple opinions to ensure you are getting the best individualized treatment.

PAD increases risk for heart attack, stroke, amputation. Three in 5 people who have a heart attack, already have plaque build-up in their legs. And as mentioned above, more than 200,000 people have lower limb amputations due to PAD which went untreated.

Say, "Hey Doc, measure the blood flow in my leg arteries to check for artery blockages."