Common signs
- Cramping in the calf, thigh, or buttock with walking
- Foot or toe pain at night or at rest
- A foot or leg wound that isn't healing
- A foot that's cold, pale, or discolored
- Diabetes with any foot wound — arteries should be checked
How I treat it
- Vascular workup — ultrasound and circulation testing in our office lab
- Angiography & endovascular repair — minimally invasive, through a small puncture: balloon angioplasty, stenting, and atherectomy to reopen blocked arteries
- Open & hybrid surgery — bypass and combined approaches when that's the more durable answer
- Wound care & hyperbaric oxygen therapy — I work with wound care centers and use hyperbaric oxygen therapy where it helps hard-to-heal wounds close after flow is restored
Common questions
What's the difference between PAD and CLTI?
PAD is narrowing of the leg arteries — often noticed as cramping with walking that eases with rest. CLTI (chronic limb-threatening ischemia) is the advanced stage, with pain at rest, wounds that won't heal, or tissue loss. CLTI puts the limb itself at risk and needs prompt evaluation.
Does PAD always mean surgery?
No. Many people do well with a structured walking program, medication, and risk-factor treatment. Procedures are considered when symptoms limit your life or when the limb is threatened.
How quickly should a non-healing foot wound be seen?
Quickly. A wound that isn't healing deserves an arterial evaluation, because restoring blood flow is what allows wound care to work. Time matters for saving a limb.