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A Guide to Peripheral Arterial Disease

YOUR GUIDE TO PAD WITH AN INTRODUCTION TO IN-OFFICE TESTING UTILIZING PADNET

Article by Dr. Chelsea Viola, Board Certified Podiatrist

Photography by Biomedix

Peripheral Arterial Disease (PAD) is a common condition that affects blood vessels outside the heart and brain, primarily those that supply the upper and lower limbs. As podiatrists, we treat many patients who have been diagnosed with PAD and monitor their feet for changes. Many of our patients have not been diagnosed with PAD, but we can help screen for this disease in the office. 

Recognizing the Signs: Symptoms of Peripheral Arterial Disease

Peripheral Arterial Disease (PAD) often manifests with subtle yet persistent symptoms that should not be ignored. Being aware of these signs can prompt early detection and intervention. If you're experiencing any of the following symptoms, it's essential to discuss them with your healthcare provider and consider undergoing in-office testing for PAD. In the lower limbs, if you are experiencing any of these symptoms, you may qualify for in-office testing for PAD. 

Leg Pain or Discomfort:

One of the hallmark symptoms of PAD is pain or discomfort in the legs, particularly during physical activity like walking. This pain, known as claudication, is often described as cramping, aching, or fatigue and typically occurs in the calf muscles. The discomfort tends to subside with rest but returns upon resuming activity. In an office visit, if we suspect PAD, we may ask you, “How many blocks can you walk until you feel pain or cramping in your calf muscles?” 

Numbness or Weakness:

PAD can lead to reduced blood flow to the extremities, resulting in numbness or weakness, especially in the legs. If you notice persistent sensations of tingling or weakness in your lower limbs, it may be indicative of compromised blood circulation. 

Coldness or Changes in Skin Color:

Poor blood flow can cause noticeable changes in skin temperature and color. If you observe that your legs or feet feel unusually cold or if the skin appears pale or bluish, it could be a sign of reduced circulation associated with PAD.

Slow-Healing Wounds or Sores:

Inadequate blood supply hinders the body's natural healing processes. We need blood to be able to get to a wound in order to heal it. If you notice wounds or sores on your feet or legs taking longer than usual to heal, it may be an indication of compromised vascular health. PAD may be closing or obstructing the blood vessels to your feet.

Poor Nail and Hair Growth:

Peripheral Arterial Disease can impact the growth of nails and hair on the affected limb. Without proper blood flowing to the feet and toes, you may notice decreased hair growth or a cessation of hair growth in your legs, feet, or toes. You may also notice that the toenails have also stopped growing or have slowed in their growth dramatically. 


As you can see, PAD comes with many potential symptoms. Fortunately, diagnosing PAD has become more convenient with advanced in-office testing.

In-Office Testing for PAD:

Vale Foot and Ankle Surgery, PLLC has partnered with Biomedix and is now equipped with state-of-the-art technology called PADnet to perform comprehensive tests for PAD, providing accurate and timely results. Three key tests—Ankle Brachial Index (ABI), Toe Brachial Index (TBI), and Pulse Volume Recordings (PVR)—play a vital role in diagnosing and evaluating the severity of PAD. These tests are exactly what we can perform with PADnet. For a video describing PAD and the PADnet process, please click here.

Ankle Brachial Index (ABI):

ABI is a non-invasive test that compares the blood pressure in your ankles to that in your arms. A blood pressure cuff is placed on each arm and ankle, and the results help determine the efficiency of blood flow to your extremities. A lower ABI ratio may indicate blockages in the arteries, raising suspicion for PAD.

How it's Utilized:

  • ABI is a primary screening tool for PAD.
  • It helps identify the location and severity of arterial blockages.
  • The test is quick, painless, and provides valuable insights into your vascular health.

Toe Brachial Index (TBI):

Similar to ABI, TBI measures the blood pressure in your toes compared to your arms. This test is particularly useful when traditional ABI results are inconclusive or when arterial disease is suspected in the smaller arteries of the foot.

How it's Utilized:

  • TBI offers a more detailed assessment of blood flow to the toes.
  • It helps identify peripheral arterial disease in specific areas that may be missed by ABI alone.
  • TBI enhances diagnostic accuracy and aids in treatment planning.

Pulse Volume Recordings (PVR):

PVR measures the changes in blood volume in your limbs as a result of each heartbeat. This test provides a waveform that can help detect abnormalities in blood flow.

How it's Utilized:

  • PVR provides a dynamic assessment of blood flow patterns.
  • It aids in identifying the location and severity of arterial obstructions.
  • PVR is often used in conjunction with ABI and TBI for a comprehensive evaluation.

Early detection of Peripheral Arterial Disease is crucial for effective management and improved outcomes. Our in-office testing procedures, including ABI, TBI, and PVR, provide a thorough assessment of your lower limb vascular health and can guide appropriate interventions and prevent the progression of PAD.

At Vale Foot and Ankle Surgery, PLLC, all three of our offices offer this testing on specific days. If you are unsure if what you’re experiencing could be attributed to Peripheral Arterial Disease, please do not hesitate to call our office at (203) 941-6999 and make an appointment with one of our podiatrists. Our expertise as foot doctors makes us qualified to identify potential issues in circulation. If you qualify for in-office testing and it shows a potential diagnosis of Peripheral Arterial Disease, you will be referred to a vascular physician (a circulation specialist) who will then be able to offer a variety of treatment options. Visit our website at www.valepodiatry.com for more information, including a video made specifically for patients regarding the entire PADnet process!

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