Peripheral Artery Disease (PAD)

Peripheral Artery Disease (PAD)

Peripheral Vascular Disease (PVD)

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Cardiologists and vascular surgeons at Duke use novel techniques and minimally invasive procedures to widen 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 heart attack, stroke, and amputation.

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About Peripheral Artery Disease

PAD is a narrowing or blockage of your arteries -- vessels that bring blood to your major organ systems and your limbs. PAD is usually caused by atherosclerosis -- the buildup of plaques made of fat, cholesterol, calcium, and other substances on the inner walls of your blood vessels. This prevents your blood from flowing normally. Often, PAD has no symptoms. Some people may have aching, pain, or numbness in their leg muscles when they 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.

While PAD usually affects the arteries in your legs, it can also affect arteries to your arms, head, and vital organs. If you have PAD, you should take it seriously, whether you have painful symptoms or none at all. Sometimes it can lead to serious problems, including heart attack, stroke, and amputation.

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

Expert Diagnosis and Management of Peripheral Artery Disease

Our specialists use advanced screening to identify PAD at every stage. If you have advanced disease, we use a combination of physical therapy, medicines, surgery, and/or minimally invasive procedures as part of your individualized treatment plan.
Duke is deeply involved in research, including: 
  • Stem cell research 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
  • The newest atherectomy devices and laser therapies to open blood vessels
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Screenings and Tests

Ankle-Brachial Index (ABI)

An ABI helps us determine whether your legs are affected by peripheral vascular disease. The blood pressure in your ankle is compared to the blood pressure in your arm while an ultrasound device listens to and compares the flow of blood in both areas.


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

X-ray, CT, and MRI

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


Best Heart Hospital in NC
When it comes to your heart care, you want the very best. Duke University Hospital's nationally ranked cardiology and heart surgery program is ranked the best in North Carolina by U.S. News & World Report for 2019–2020.


Healthy Lifestyle Changes

We offer cardiac rehabilitation and prevention programs as well as tobacco cessations clinics. 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 boost your self-confidence to help you work toward a heart-healthy lifestyle.


Our providers are well versed in all the current medical therapies, including use of statins and anti-clotting drugs to improve blood flow, control symptoms, and slow the progression of peripheral artery disease.

Novel Therapies Through Clinical Trials

As a Duke patient, you may be eligible to participate in one of our clinical trials. Our providers are consistently asked to participate in trials studying the latest treatment advances -- including newer medications (such as anti-clotting drugs), dietary supplements, and new medical devices -- to reduce the progression of this disease.

Minimally Invasive Procedures

The provider inserts a thin, flexible tube called a catheter into a blood vessel and guides it to your narrowed artery to open it. Minimally invasive therapies include:

  • Balloon angioplasty: A small balloon is inflated within the artery to push aside the blockages.
  • Stenting: A tiny tube-shaped device, called a stent, is inserted into the artery after balloon angioplasty and expanded to hold the artery open. Some stents are coated with a drug to reduce the risk of blood clots in the artery.
  • Atherectomy: A device inserted into the artery via a catheter gently scrapes away fatty deposits.
  • Laser ablation: A laser painlessly vaporizes fatty deposits into particles tiny enough to be safely absorbed into the bloodstream.


Hybrid Procedures

Duke is one of the few centers in the southeast that can combine minimally invasive interventions and open surgical approaches to open your clogged arteries and improve blood flow. Your team will determine the right approach for you based on your medical condition, your individual 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 vascular disease or are at risk for amputation, our 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 annually. You experience less pain and scarring and recover faster than with surgical approaches.

Dedicated Support for Limb Loss
We have a dedicated team of providers, 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, often enabling you to regain the ability to walk.

Reviewed: 10/19/2018