Peripheral Artery Disease (PAD)

In some patients, clogged arteries are not limited just to the heart. Plaque buildup can affect the arteries of the neck (carotid arteries), arteries of the kidneys (renal arteries), arteries of the legs and arms, and the aorta. Peripheral arterial disease (PAD) is the narrowing or blockage of these blood vessels which can result in leg or arm discomfort while exercising, leg ulcers (sores in the feet that take more than two weeks to heal) and other serious complications. PAD affects almost 10 million patients, yet it remains one of the most underdiagnosed and undertreated conditions.

At Weill Cornell Medicine our team of specialists includes experts in diagnostic imaging and specialized procedures. Our specialists have expertise in detecting vascular conditions and focus specifically on detecting and treating peripheral arterial disease. These vascular specialists are board certified and specifically trained in vascular or endovascular medicine, cardiovascular disease and interventional cardiology.

Treatment Options

As a patient you will receive a unique treatment plan tailored to your specific condition and lifestyle goals. Treatment options may include: 

• Medical Therapy: Medical therapy is an integral part of treatment for all patients with peripheral arterial disease. Medications are used to target leg or arm discomfort, as well as treat risk factors - diabetes, hypertension and high cholesterol.
• Exercise Therapy: Exercise therapy can help increase the distance and speed at which you can walk without pain.
• Tobacco Cessation: Weill Cornell Medicine provides resources and support for stopping the use of all tobacco.
• Minimally Invasive Endovascular Treatments: Our experienced interventional cardiologists specialize in performing minimally invasive procedures. These are performed through a small opening in the wrist or groin (not open-heart surgery), resulting in a shorter recovery period, same day discharge and fewer complications. Clogged arteries can be treated with balloon angioplasty, lithotripsy (use of shock waves to break down calcium), placement of stents, or atherectomy (plaque excision from the artery).

Areas of Expertise

Angioplasty, Drug-Coated Balloon Angioplasty and Stenting for PAD: Our physicians use a small balloon-tipped catheter that is threaded through the clogged artery to expand it. A stent may be inserted to relieve the blockage and to keep the artery open. Bare metal stents or drug-eluting stents are commonly used to treat clogged arteries.

Atherectomy (Plaque Excision): During this procedure a catheter is used to remove the plaque from the artery. Our specialists use cutting-edge technology, including rotational, excisional, orbital, and laser atherectomy.

Carotid Disease and Carotid Stenting: Carotid artery angiography and stenting (with filter devices in the arteries of the neck that catch plaque particles) can be performed for patients with severe blockages of carotid arteries, particularly in those experiencing strokes or mini strokes.

Chronic Total Occlusions (CTO): CTO is the complete blockage of the peripheral artery. Our physicians can relieve blockages in arteries that are entirely blocked, particularly blockages that have been present for months and sometimes for years.

Chronic Venous Insufficiency (CVI): Chronic venous insufficiency describes a condition affecting the veins in the legs with venous hypertension. This can lead to a pain, swelling, edema, skin changes, and ulcerations in the legs. The latest minimally invasive approaches for treatment of venous disease include vein radiofrequency ablation (RFA), a technique in which a catheter delivers microwave radiation to seal/close veins that have “reflux.”

Endovascular Repair of Abdominal Aortic Aneurysms (AAA): AAA is a minimally invasive treatment for many people with an abdominal aortic aneurysm, and an alternative for some who do not qualify for open surgery.

Limb Threatening Ischemia: A condition categorized by reduced blood flow to the limbs, especially the arms or legs. This condition causes limb discomfort at rest and may lead to the presence of ulcers or gangrenes.

Inferior Vena Cava Filter Placement and Retrieval: During these procedures small filter devices are placed in a large vein (vena cava) to prevent clots from traveling to the lungs. These methods can be used for both prevention and treatment of patients with clots formed in deep veins.

Intravascular Lithotripsy (IVL): Lithotripsy is a balloon-based technology used to treat calcified blockages in blood vessels. It involves using shock waves to break down the calcium deposits, making it easier to place stents or perform other interventions to improve blood flow. 

Intravascular Ultrasound and Fractional Flow Reserve (FFR): An ultrasound catheter can be threaded through clogged arteries to determine the severity and location of a given blockage. A Fractional Flow Reserve wire is threaded through a blockage and used to measure whether the blockage is significantly reducing blood supply and needs further treatment.

Renovascular Disease: Renovascular disease is the narrowing or blockage of the renal arteries. Clogged renal arteries can lead to hypertension, which is difficult to treat with medications, kidney damage/failure or heart failure. However, these clogged kidney arteries can be treated with angioplasty and stenting.

Renal denervation: Renal denervation is a minimally invasive procedure used to treat resistant hypertension (high blood pressure that does not respond to medications). During this procedure an interventional cardiologist uses a small catheter to send radiofrequency or ultrasound (heat) energy to the renal arteries, the blood vessels supplying blood to the kidneys. This energy destroys (ablates) renal nerves without damaging the arteries. The reduced nerve activity causes improvement in blood pressure.