Comprehensive peripheral arterial disease evaluation, ABI testing, and vascular risk management by board-certified FACC cardiologists at Cross County Cardiology — 5 NJ locations.

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What Is Peripheral Arterial Disease?

Peripheral arterial disease (PAD) is atherosclerosis — plaque buildup — occurring in the arteries that supply blood to the legs, arms, and pelvic region. It is the same disease process that causes coronary artery disease (CAD) and carotid artery disease, and patients with PAD carry a substantially elevated risk of heart attack and stroke regardless of whether they have coronary symptoms. PAD affects approximately 8–12 million Americans and is significantly underdiagnosed.

PAD Symptoms

Intermittent Claudication — The hallmark symptom of PAD. Cramping, aching, or fatigue in the calves, thighs, or buttocks that occurs during walking and is relieved within minutes of rest. Claudication occurs because narrowed arteries cannot deliver adequate blood flow to meet exercising muscle demands.

Rest Pain — Severe burning or aching pain in the foot or toes at rest, particularly at night, indicates critical limb ischemia — a vascular emergency requiring urgent evaluation.

Non-Healing Wounds — Slow-healing ulcers on the feet, toes, or lower legs are a serious sign of severely reduced arterial blood flow. Without intervention, these can progress to gangrene and limb loss.

Asymptomatic PAD — A significant proportion of patients with PAD have no leg symptoms but remain at elevated cardiovascular risk. Screening with ABI testing is appropriate for high-risk individuals.

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Diagnosing PAD

Ankle-Brachial Index (ABI) — The primary non-invasive test for PAD. We measure blood pressure at the ankle and arm and calculate the ratio. An ABI below 0.90 confirms PAD; below 0.40 indicates severe PAD. The ABI is performed in-office at all Cross County Cardiology locations.

Segmental Pressure Measurements — Localize the level of arterial obstruction within the leg.

Duplex Ultrasound — Non-invasive imaging of arterial blood flow and velocity to identify stenotic segments.

CT Angiography / MR Angiography — For detailed anatomical mapping prior to revascularization planning. Coordinated through our hospital affiliates.

PAD Treatment Options

Cardiovascular Risk Reduction — Treating PAD means treating the systemic atherosclerotic disease driving it. We aggressively manage all cardiovascular risk factors: high-intensity statin therapy (LDL target <70 mg/dL), blood pressure control, diabetes management, antiplatelet therapy, and smoking cessation.

Antiplatelet Therapy — Aspirin or clopidogrel reduces the risk of major cardiovascular events (heart attack, stroke, cardiovascular death) in patients with PAD. We determine the most appropriate antiplatelet regimen for each patient.

Supervised Exercise Therapy — The most effective treatment for claudication. Supervised walking programs improve walking distance by 150–200%, stimulate collateral vessel development, and improve quality of life. We coordinate referrals to cardiac rehabilitation programs.

Cilostazol — An FDA-approved medication for claudication that increases walking distance. Used when exercise therapy is insufficient.

Referral for Revascularization — For patients with critical limb ischemia, severe claudication limiting daily activities, or non-healing wounds unresponsive to medical therapy, we coordinate urgent referral to vascular surgery for angioplasty, stenting, or bypass grafting.

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Why Cross County Cardiology for PAD

• In-office ABI testing at all 5 NJ locations
• Comprehensive cardiovascular risk management for systemic atherosclerosis
• Board-certified FACC cardiologists experienced in vascular medicine
• Seamless vascular surgery and interventional radiology referrals
• Same-week appointments with urgent access for critical cases

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Frequently Asked Questions

What does PAD leg pain feel like?

Classic PAD claudication presents as cramping, aching, fatigue, or heaviness in the calf, thigh, or buttock during walking that disappears within 5–10 minutes of rest. It is reproducible — occurring at roughly the same walking distance each time. This distinguishes it from arthritis or nerve pain, which may not follow this predictable pattern.

Is PAD dangerous even without leg pain?

Yes. Patients with asymptomatic PAD (confirmed by ABI testing) have the same elevated risk of heart attack and stroke as symptomatic patients. PAD is a marker of systemic atherosclerosis. All PAD patients — symptomatic or not — require aggressive cardiovascular risk reduction.

Can PAD be reversed?

Atherosclerosis underlying PAD cannot be fully reversed, but progression can be halted and symptoms significantly improved with aggressive medical therapy, exercise, and revascularization when appropriate. The primary goal is preventing limb loss, heart attack, and stroke.

When is surgery needed for PAD?

Surgical or endovascular revascularization is considered for patients with critical limb ischemia (rest pain, non-healing wounds, gangrene) or for patients with severe claudication significantly limiting daily activities who have not responded to supervised exercise and medication. Most patients with claudication alone are managed successfully without surgery.

Should I stop smoking if I have PAD?

Smoking cessation is the single most important intervention in PAD management. Smoking accelerates atherosclerosis, worsens claudication, dramatically increases amputation risk, and negates the benefits of revascularization. We provide smoking cessation counseling and medication assistance as part of all PAD treatment plans.