Peripheral Artery Disease (PAD)

Peripheral Vascular Disease (PVD), Chronic Limb-Threatening Ischemia (CLTI)

Heart and vascular specialists at Duke use novel techniques and minimally invasive procedures to open blood vessels narrowed by peripheral artery disease (PAD), also known as peripheral vascular disease (PVD). Our doctors evaluate your symptoms and risk factors, and we offer the full range of therapies to restore blood flow to your arms and legs. Our goals are to treat your condition, prevent progression, and minimize your risk for serious complications.

Find a Peripheral Artery Disease (PAD) Doctor

Matching Results

Filter Results

Filter by:

Use My Current Location

Located Near You

Loading Results

Showing of Doctors

Load More View All

About Atherosclerosis and Peripheral Artery Disease

Atherosclerosis is a narrowing of or blockage in your arteries -- vessels that bring blood to your major organ systems and limbs. This narrowing is caused by plaque (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. However, it can lead to heart attack, stroke, and amputation.

Peripheral artery disease (PAD) is atherosclerosis in arteries in the arms and 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 leg pain even at rest, and it can lead to skin wounds or ulcers.

Tests for Peripheral Artery Disease

Our specialists use advanced screening to identify PAD at every stage.

Ankle-Brachial Index (ABI)

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.

Ultrasound

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.

A unique type of ultrasound imaging called duplex ultrasound is specifically designed to assess blood flow and valve function.

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 intravenously, can help doctors identify narrowed areas in your arteries.

Our Locations

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

Find a Location

Nonsurgical Treatments

Lifestyle Changes
To help reduce symptoms and limit disease progression, we offer services like heart disease prevention, tobacco cessation, and supervised walking exercise therapy. Our caring and committed professionals can help you lose weight, stop smoking, exercise, and lower your blood pressure. We monitor your progress, help you overcome symptoms such as leg pain, and help you establish a healthier lifestyle.

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

Minimally Invasive Catheterization (Endovascular) Procedures

When recommending minimally invasive catheterization (or endovascular) procedures, your doctors will consider your blockage type and location as well as your anatomy, other health conditions, previous treatments, and current medications when deciding which approach is right for you. We customize your care with the goal of achieving the best possible outcome with the lowest risk of complications and the easiest recovery.

A thin, flexible tube called a catheter is inserted into a blood vessel and guided to your narrowed artery. Doctors may inject contrast dye through the catheter and/or use intravascular ultrasound (IVUS) -- placing a tiny ultrasound device inside your problematic artery -- to learn as much as possible about your condition before choosing one or more of the following techniques.

Balloon Angioplasty
A small balloon is inflated within the artery to expand a narrowed area or push back plaque. This option opens the narrowed artery quickly, and it does not require a device to be left behind.

Stenting
A tiny tube made of metal mesh called a stent is inserted into the narrowed artery and left there to keep the artery open. This technique restores blood flow quickly and aims for long-term success.

Some stents are coated with medication that helps prevent blood clots from forming in the artery. Newer bioabsorbable stents eventually dissolve, so you only have an embedded device for a limited time.

Atherectomy
Deposits of cholesterol and calcium are removed from the artery using tools like a laser, burr, or drill. This option can increase the success of balloon angioplasty and stenting.

Lithoplasty
A specialized balloon catheter uses sound waves to break up plaque within arteries. This technique is especially effective for tough, calcified blockages that other tools may not be able to treat.

Surgical Options

For people with challenging anatomy and/or who have severe peripheral artery disease, chronic limb-threatening ischemia, or are at risk for amputation, surgery may be your best option.

Hybrid Procedures
Duke vascular specialists combine minimally invasive interventions and traditional surgery to open your clogged arteries and improve blood flow.

Bypass Graft Surgery
Surgeons harvest a vein from another part of your body or use a synthetic graft to create a new path for blood flow that bypasses the blocked artery.

Deep Vein Arterialization
Surgeons remove the valves inside some veins, which usually transport blood back to the heart, and reroute veins to convert them to arteries, which transport oxygenated blood from the heart to the body. This advanced surgery is only available at a highly specialized centers like Duke.

Call for an Appointment

855-855-6484

Why Choose Duke

Experience and Expertise
Our board-certified vascular surgeons and interventional cardiologists perform thousands of minimally invasive, catheter-based procedures every year. These approaches reduce pain, scarring, and recovery time. We also offer the latest surgeries to treat even the most severe cases of peripheral artery disease.

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 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 2025–2026.

This page was medically reviewed on 10/09/2024 by

Tristen T. Chun, MD, MS | Vascular Surgeon