Peripheral Artery Disease (PAD)

Peripheral Vascular Disease (PVD)

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Heart and vascular specialists at Duke use novel techniques and minimally invasive procedures to treat arteries narrowed by peripheral artery disease, also known as peripheral vascular disease. Our physicians evaluate your risk factors and use the latest treatment advances to restore blood flow to your arms and legs. Our goal is to minimize your risk for serious complications.

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About Atherosclerosis and Peripheral Artery Disease

Atherosclerosis is a narrowing or blockage of your arteries -- vessels that bring blood to your major organ systems and your limbs. This narrowing is caused by a buildup of fat, cholesterol, calcium, and other substances on the inner walls of your blood vessels, which prevents your blood from flowing normally. Often, atherosclerosis has no symptoms. It can lead to heart attack, stroke, and amputation.

Peripheral artery disease (PAD) is atherosclerosis in arteries in the legs. PAD may cause aching, pain, or numbness in the leg muscles when you walk or climb stairs. This is called claudication; it happens when the muscles that are performing the work don’t get enough oxygen-rich blood. A more severe manifestation of PAD is chronic limb-threatening ischemia (CLTI). CLTI causes foot wounds or ulcers and leg pain. 

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Tests for Peripheral Artery Disease

Our specialists use advanced screening to identify PAD at every stage. All of these tests are simple and painless, and they usually take about 30 to 60 minutes.

Ankle-Brachial Index (ABI)

An ABI helps doctors determine whether your legs are affected by PAD. The blood pressure in your ankle is measured and compared to the blood pressure in your arm. Meanwhile, an ultrasound device listens to and compares the flow of blood in both areas.


This test uses sound waves to measure the speed of blood flow in your arteries and veins. It also generates images that help determine where blood flow is restricted.

CT and MRI

Advanced CT and MRI imaging helps assess damage to your blood vessels. High-resolution images combined with angiography, which uses a contrast dye injected into your arm, can help doctors more clearly identify narrowed areas in your arteries.

Peripheral Artery Disease Treatment

Lifestyle Changes

To help you make healthy changes, we offer services like cardiac disease prevention and tobacco cessation. Our caring and committed professionals can help you lose weight, stop smoking, start exercising, and lower your blood pressure. We monitor your progress, help you overcome symptoms such as leg pain, and help you work toward a heart-healthy lifestyle.


Our providers may suggest medications that improve blood flow, control symptoms, and slow the progression of peripheral artery disease.

Minimally Invasive Procedures

A thin, flexible tube called a catheter is inserted into a blood vessel and guided to your narrowed artery. Contrast dye can be injected through the catheter to identify any blockages. Then, your doctors may use one or more of the following techniques to treat them.

  • Balloon angioplasty: A small balloon is inflated within the artery to open any blockages.
  • Stenting: A tiny, tube-shaped device called a stent is inserted into the artery and left there to hold the artery open. Some stents are coated with a medicine that helps prevent blood clots from forming in the artery.
  • Atherectomy: A device gently scrapes away fatty deposits.

Hybrid Procedures

Duke is one of the few centers in the southeast that can combine minimally invasive interventions and traditional surgery to open your clogged arteries and improve blood flow. Your team will determine the right approach for you based on your medical condition, your anatomy, and the size and shape of your arteries. We customize your care with the goal of giving you the best possible outcome with the lowest risk of complications and the easiest recovery.

Bypass Graft Surgery

If you have severe peripheral artery disease or are at risk for amputation, surgeons may use a vein from another part of your body to create a new path for blood flow that bypasses the blocked artery. 

Why Choose Duke

Experience and Expertise
Our board-certified vascular surgeons and interventional cardiologists perform more than 3,000 minimally invasive, catheter-based procedures every year. These approaches reduce pain, scarring, and recovery time.

Dedicated Support for Limb Loss
We have a dedicated team of doctors, nurses, prosthetists, and therapists who are here to help and support you and your loved ones in the event your disease results in limb loss. Specialists from across Duke Health collaborate to provide comprehensive care, from before your operation through prosthesis fitting and rehabilitation and helping you to regain the ability to walk.

Novel Therapies Through Clinical Trials
You may be eligible to participate in one of our clinical trials. Our providers consistently join or lead trials studying the latest treatment advances -- including new medications, dietary supplements, and medical devices -- to reduce the progression of this disease. Some recent PAD research includes using: 

  • Stem cells to grow new blood vessels
  • Human-tissue-engineered blood vessels for bypass procedures
  • Drug-eluting balloons and stents that can be placed through small incisions to reduce scarring and recovery time
  • New atherectomy devices and laser therapies to open blood vessels
Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 06/03/2022 by