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Cardiolucent

Condition

Peripheral Artery Disease (PAD)

Leg artery narrowing that signals systemic atherosclerosis and elevated heart risk.

Peripheral artery disease (PAD) is one form of aortic and peripheral vascular disease in which atherosclerotic plaque narrows the arteries supplying the legs, and sometimes the arms. The classic symptom is leg pain or cramping with walking that resolves with rest (claudication), though many patients have no symptoms at all. Because PAD is a marker of generalized atherosclerosis, patients with PAD have substantially elevated risk of heart attack and stroke even when their legs feel fine. Recognizing and treating PAD is therefore both about preserving limbs and protecting the heart and brain. Dr. Kedan uses noninvasive vascular testing in coordination with risk-factor optimization to manage PAD as a systemic, not local, problem.

What Cardiolucent Evaluates

  • Walking-distance history and Edinburgh-style claudication questioning
  • Lower-extremity pulse examination, skin assessment, and POCUS
  • Ankle-brachial index (ABI) and segmental pressure testing
  • Vascular Doppler studies of the lower extremities when indicated
  • Concurrent coronary and carotid risk assessment
  • Aggressive lipid, blood pressure, glucose, and tobacco-cessation management
  • Coordination with vascular surgery and interventional cardiology at Cedars-Sinai for revascularization when needed

Common Symptoms

  • Leg cramping, aching, or fatigue with walking that resolves with rest (claudication)
  • Cool or pale skin in the affected limb
  • Slow-healing wounds on the feet or toes
  • Loss of hair on the legs or feet
  • Diminished or absent foot pulses
  • Rest pain in the feet, particularly at night, in more advanced disease
  • Many patients are asymptomatic and diagnosed only with screening

Risk Factors

  • Tobacco use, current or past
  • Diabetes
  • Hypertension
  • High cholesterol
  • Chronic kidney disease
  • Age over 65, or over 50 with another risk factor
  • Family history of vascular disease
  • Known coronary artery disease or stroke

How Cardiolucent Approaches Treatment

Treatment of PAD has two parallel goals: protect the heart and brain from future events, and preserve leg function. Dr. Kedan combines aggressive lipid lowering (typically high-intensity statins, sometimes with PCSK9 inhibitors), antiplatelet therapy, blood pressure and glucose control, and structured walking programs that meaningfully extend pain-free distance. When symptoms remain limiting or limb threat is present, he coordinates revascularization — endovascular or surgical — with vascular specialists at Cedars-Sinai. Tobacco cessation, when relevant, is the single highest-yield intervention.

Common Questions

Frequently Asked Questions

What is peripheral artery disease?
PAD is narrowing of the arteries outside the heart, most commonly in the legs, caused by atherosclerotic plaque. It restricts blood flow to the limbs and is a strong indicator that similar disease is present elsewhere in the body.
How is PAD related to aortic atherosclerosis and peripheral vascular disease in general?
PAD is one subset of the broader category of aortic atherosclerosis and peripheral vascular disease. It specifically refers to lower-extremity arterial disease, while the umbrella also includes carotid disease, renal artery disease, and aortic plaque elsewhere.
What symptoms should I watch for?
Classic symptoms include cramping, fatigue, or aching in the calves, thighs, or buttocks during walking that resolves within a few minutes of rest. Cool skin, slow-healing foot wounds, or pain in the feet at night are signs of more advanced disease and warrant prompt evaluation.
I have no leg symptoms — could I still have PAD?
Yes. A significant proportion of patients with PAD have no classic claudication, particularly those who are sedentary or have diabetic neuropathy. Routine screening with an ankle-brachial index is reasonable in higher-risk patients even without symptoms.
How is PAD diagnosed?
The ankle-brachial index (ABI), which compares blood pressure at the ankle to the arm, is the standard noninvasive screening test. Segmental pressures, pulse-volume recordings, and vascular Doppler studies localize the disease. CT or MR angiography may be added when revascularization is being planned.
Why does PAD raise my risk of heart attack?
Atherosclerosis is a systemic process. Patients with PAD almost always have plaque in other arterial beds, and the leading cause of death in PAD is cardiovascular events, not limb loss. Treating PAD is therefore as much about heart and brain protection as it is about the legs.
How is PAD treated?
Medical therapy emphasizes high-intensity lipid lowering, antiplatelet therapy, blood pressure control, glucose management, and tobacco cessation. Structured walking programs improve symptoms and walking distance significantly. Endovascular procedures or bypass surgery are reserved for limiting symptoms or threatened limb.
Does walking really help if it hurts?
Yes — supervised exercise therapy is one of the best-proven treatments for claudication. By walking to mild discomfort, resting briefly, and resuming, patients steadily extend the distance they can cover. This effect is robust and often comparable to procedural treatment for milder disease.
Will I need a stent or surgery?
Most patients are managed successfully without procedures. Revascularization is considered for severely limiting symptoms despite medical therapy and exercise, or when there is rest pain, non-healing wounds, or threatened limb. Dr. Kedan coordinates these decisions with vascular surgery at Cedars-Sinai.
How do I schedule a consultation?
Call (310) 304-5555 or use the contact form to schedule with Dr. Kedan at the Beverly Hills office. Cardiolucent is a concierge practice that does not bill Medicare or insurance; a detailed superbill is provided for any out-of-network reimbursement.

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The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.