Peripheral arterial disease (PAD) – intermittent claudication
"Window-shopping disease" gets its name from the fact that those affected can only walk short distances before having to stop and take a break, just like when window-shopping. However, it is caused by a serious condition medically known as peripheral arterial disease (PAD for short). PAD is also known as smoker's leg.
It refers to the progressive narrowing of the arteries that supply the limbs. In the legs, this is caused by atherosclerotic changes in the pelvic or leg arteries, which increasingly reduce blood flow to the legs. The tissue no longer receives enough oxygen and nutrients, which can cause pain. This results in the symptoms described above. In the worst case, the tissue dies and amputation may become necessary.
- In about 50 percent of cases, PAD is found in the thigh artery. The pulse behind the knee and in the foot can then no longer be felt. Pain occurs mainly in the calf.
- In about 30 percent of cases, the narrowing is located in the pelvic arteries. The pulse in the groin cannot be felt either. Pain also occurs in the buttocks and thigh. If the narrowing is located slightly higher up-namely in the abdominal aorta before the pelvic arteries branch off-this is known as Leriche syndrome. Here too, the legs no longer receive an adequate blood supply. This can also lead to bladder and rectal problems and, in men, erectile problems that may progress to impotence.
- Twenty percent of PAD cases occur in the arteries of the lower legs. In this case, the pulse in the foot can no longer be felt, and the pain affects the sole of the foot.
- The arteries in the arms are less commonly affected by PAD.
For this reason, the presence of PAD is also considered a risk factor for other conditions such as heart attack, stroke or sudden cardiac death.
The development of PAD also often goes unnoticed at first. Symptoms only occur once the narrowing reaches a certain degree.
Peripheral arterial disease can therefore be divided into different stages:
How is PAD detected?
If PAD is suspected, the doctor will determine the ABI value. To do this, they measure the blood pressure in the arm and above the ankle using a cuff and a Doppler ultrasound probe. The systolic pressure at the ankle is then divided by the systolic pressure in the upper arm. If the blood vessels are healthy, the pressures are roughly the same and the ABI value is approximately 1.0. PAD is present if the value is 0.9 or less. This is then investigated further using an ultrasound examination. If this is not sufficient or surgery is planned, further examination can be performed using magnetic resonance imaging, angiography or a catheter.
What can be done?
Lifestyle changes are also essential for PAD to slow the progression of the disease. Walking is particularly important in this case, as walking training is vascular training.
Drug therapy may also be necessary in some cases. In severe cases, invasive treatment options include widening the blood vessel with a catheter or inserting a stent. During vascular surgery, the blood vessel can be reopened or a bypass can be created.
Of course, it is best not to let things get that far in the first place and to prevent the disease from developing or progressing through a healthy lifestyle and exercise.
Sources:
This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2025).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
