In this episode, we cover peripheral artery disease (PAD)—a chronic atherosclerotic condition that leads to reduced blood flow and limb ischemia, most commonly in the lower extremities. We break down the underlying pathophysiology of progressive arterial narrowing and impaired oxygen delivery, and highlight major risk factors such as smoking (the strongest contributor), diabetes, hypertension, and hyperlipidemia. Clinically, we focus on recognizing intermittent claudication as the hallmark presentation, along with advanced findings like rest pain, nonhealing ulcers, and gangrene. Diagnostic strategies are reviewed with emphasis on the ankle-brachial index (ABI) as the first-line test, followed by vascular imaging when indicated. Management includes aggressive risk factor modification, structured exercise therapy, antiplatelet and statin therapy, and revascularization for severe disease. Key pearls reinforce that PAD is not just a limb disease—but a marker of systemic atherosclerosis with significant cardiovascular risk.

References

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2. Gerhard-Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Circulation. 2017; 135(12).
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4. McDermott MM. Peripheral Artery Disease in the Legs N Engl J Med. 2026; 394(5):486-496.