What is peripheral arterial disease (PAD)?

peripheral arterial disease (PAD) is a common condition in which a build-up of fatty deposits in the arteries reduces the blood flow to the legs and feet. The major cause of PAD is narrowing of blood vessels due to atherosclerosis.

Many people with PAD have no symptoms. However, some develop a painful ache in their legs when they walk.The pain can range from mild to severe, and usually disappears after a few minutes of rest. The medical term for this is 'intermittent claudication'.

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

Symptoms of PAD and critical limb ischemia (CLI)

The symptoms of PAD often develop slowly over time. If your symptoms develop quickly, or suddenly worsen, it could be a sign of a serious problem that requires immediate treatment. When the disease worsens, some blood vessels become almost completely blocked, which can result in severe pain at rest and non-healing wounds on the toes, the feet and calves. Ultimately, tissue may die, resulting in gangrene.

Critical limb ischemia (CLI) is a severe stage of PAD. CLI is an extremely serious complication that can be challenging to treat. People who develop CLI have a high risk of amputation of toes, (part of) the feet or even the lower leg (below the knee). Well known risk factors that increase the likelihood of developing PAD and CLI include diabetes mellitus (DM) and smoking. The risk of developing CLI is 10 to 20 times higher in patients with DM.

Symptoms of CLI include:

    A severe burning pain in legs and feet that continues even during rest
    Skin turning pale, shiny, smooth and dry
    Wounds and ulcers (open sores) on feet and legs that do not heal
    Loss of muscle mass in your legs
    Skin on toes or lower limbs becoming cold and numb, turning red and then black, and/or beginning to swell and produce foul-smelling pus, causing severe pain (gangrene)


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