Peripheral Vascular Disease: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Peripheral Vascular Disease?
A vascular surgeon (a doctor who operates on blood vessels) or a cardiologist (a heart and blood vessel doctor) usually treats peripheral vascular disease. Here, that means narrowing of the arteries in the legs. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is peripheral vascular disease?
Peripheral vascular disease (PVD) is another name for peripheral artery disease (PAD). PAD is a condition of the blood vessels that supply blood to the legs and feet. This lowers blood flow, which can injure skin, muscles, nerves, and other tissues.
Symptoms
The main symptoms of PAD are pain, achiness, fatigue, burning, or discomfort in the muscles of the feet, calves, or thighs. These symptoms most often appear during walking or exercise and go away after several minutes of rest.
Your legs or feet may feel numb when you are at rest. The legs may also feel cool to the touch, and the skin may look pale.
When PAD becomes severe, you may have:
- Pain and cramps at night.
- Skin that looks dark and blue.
- Sores that do not heal.
Causes and who gets it
PAD is commonly caused by atherosclerosis. In atherosclerosis, fatty plaque builds up on artery walls and makes them narrower.
It most often affects men over age 50, but women can have it as well.
You are at higher risk if you have a history of:
- Diabetes.
- Heart disease.
- High blood cholesterol.
- High blood pressure.
- Smoking.
- Stroke.
Possible complications include coronary artery disease. Open sores can form on the lower legs. Tissue death, called gangrene, can also happen.
How doctors diagnose it
During an exam, a provider may find:
- Weak or absent pulses in the limb.
- Lower blood pressure in the affected limb.
One test is the ankle-brachial index (ABI). It compares the blood pressure in your arms and legs.
Other tests include Doppler ultrasound of the leg, which uses sound waves to check blood flow. Angiography of the legs, including magnetic resonance angiography and CT angiography, shows the blood vessels.
Treatment
Treatment depends on how severe your PAD is. Most cases of PAD of the legs can be controlled without surgery. One goal is to lower the risk of a major health problem such as a heart attack or stroke.
Lifestyle steps are an important part of care:
- Stop smoking, because smoking narrows the arteries, lowers the blood's ability to carry oxygen, and raises the risk of blood clots. Quitting can reduce your symptoms and your risk of complications.
- Walk or do another activity to the point of pain, and alternate it with rest periods. Always talk to your provider before starting an exercise program.
- Keep your blood pressure well controlled.
Medicines may also be needed to control PAD. Aspirin or clopidogrel keep your blood from forming clots in your arteries. Possible side effects of these medicines include bleeding or an allergic reaction. Statins, which lower cholesterol, also lower your risk of complications from PAD. Do not stop taking these medicines without first talking with your provider.
If these steps do not work well enough, your provider may recommend a procedure or surgery. Angioplasty is a procedure to open narrowed or blocked arteries. The doctor may also insert a stent, a small mesh tube, to reduce the chance that the artery will narrow again. Bypass surgery uses a blood vessel from your body, or an artificial one, to make a new path around a blocked leg artery. Some people with PAD may need to have the limb removed.
When to see a doctor
Contact your provider if you have:
- Leg pain that does not go away, even when you are not walking or moving.
- New sores or ulcers.
Pay attention to any cuts, scrapes, or injuries on your feet, and see your provider right away. Tissues heal slowly and are more likely to get infected when blood flow is lower.
Call 911 or go to the emergency room right away if symptoms come on fast or suddenly get worse, such as a leg or foot that becomes cool, pale, blue, or numb. This can be a serious problem that needs treatment right away. Also call 911 for chest pain or discomfort lasting two minutes or more, trouble breathing, or fainting.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can follow your blood pressure and other risk factors over time and refer you to a vascular specialist when needed.
Common questions
Is peripheral vascular disease the same as peripheral artery disease?
Yes, MedlinePlus lists peripheral vascular disease as another name for peripheral artery disease.
Can peripheral vascular disease be controlled without surgery?
Yes, most cases of PAD of the legs can be controlled without surgery. A procedure or surgery may be recommended if lifestyle changes, an exercise program, and medicines do not work well enough.
Does smoking make peripheral vascular disease worse?
Yes, smoking narrows the arteries, lowers the blood's ability to carry oxygen, and raises the risk of blood clots. Quitting can reduce your symptoms and your risk of complications.
Sources
- MedlinePlus - Peripheral artery disease - legs
- National Heart, Lung, and Blood Institute - Peripheral Artery Disease - Treatment
- NHS - Peripheral arterial disease (PAD)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
