Peripheral arterial disease (PAD) was previously known as peripheral vascular disease. This is a very common problem of the circulation in which the arteries of the legs have narrowed, severely reducing blood flow to the legs. PAD is an under recognized condition that affects over 10 million people in the United States and 12 to 20% of all people over 65. Peripheral arterial disease is a chronic, progressive disease. Major risk factors include smoking, diabetes, chronic kidney disease, and age.


With mild to moderate peripheral arterial disease, cholesterol and calcium deposits in the artery reduce the amount of blood flow required by the legs for vigorous exercise. For this reason, crampy calf pain occurs while walking, but may not occur at rest. As the disease progresses, symptoms occur after walking just a short distance.

Rest Pain

As peripheral arterial disease becomes more advanced, blood flow is reduced more, and leg pain occurs at rest, without exercise. In this case, pain is usually in the most distal tissue – the feet, rather than the calves. Patients may feel the most pain when lying down to sleep at night, and may find that dangling the legs off the side of the bed brings relief, as gravity helps to increase blood flow. Chronic changes such as dry flaky skin, hair loss, and redness may appear in the legs and feet.


In the most advanced stage of peripheral arterial disease, open wounds may develop on the feet. These wounds may progress and get infected. It is important to have an urgent evaluation and treatment to treat these problems.

Evolution and Treatment

At San Francisco Vein and Vascular Institute, we specialize in the treatment of peripheral arterial disease. Our fully accredited vascular ultrasound lab uses state-of-the-art tools to safely diagnose and identify areas of narrowing in the leg arteries.

Based on that information, the surgeons at SFVVI have expertise in the wide range of treatment options, including the most advanced minimally invasive endovascular therapies, and open bypass surgery for the most complex cases.

Reasons to test for peripheral arterial disease include:

  1. Age over 50

  2. History of diabetes

  3. Family history of a heart attack (myocardial infarction), stroke or aneurysm

  4. A personal history of a heart attack or stroke or aneurysm

  5. If you smoke or have EVER smoked in the past

  6. Have trouble walking because of pain cramping or fatigue in the legs

  7. Pain in the legs at night

  8. An inactive lifestyle

  9. High cholesterol or a high lipid blood tes