Artery & circulation care

Peripheral Artery Disease (PAD) Evaluation and Care

Peripheral artery disease is narrowing of the arteries that carry blood to the legs and feet. We check leg circulation, explain test results such as the ankle-brachial index, and plan treatment that eases symptoms and lowers the risk of heart attack and stroke.

Overview

What PAD is

PAD develops when plaque narrows the arteries to the legs. The classic symptom is cramping, aching or tiredness in the calf, thigh or buttock while walking that eases within minutes of rest, called claudication. Only about 1 in 4 people with PAD have this classic pattern; others have different symptoms or none at all.

PAD matters beyond the legs. People with PAD have a higher risk of heart attack and stroke, so care focuses on the whole circulation.

Who may benefit

When an evaluation can help

  • Leg pain, cramping or heaviness with walking that improves with rest
  • Sores on the feet or toes that heal slowly
  • One foot that is colder or paler than the other, or weak pulses in the feet
  • Smoking history, diabetes, high blood pressure, high cholesterol or age over 65
  • Known coronary or carotid artery disease

Leg pain has many causes, including nerve, joint and muscle problems. An evaluation helps tell them apart.

Your visit

What your appointment involves

  1. HistoryWhat the leg symptoms feel like, how far you can walk, and any wounds, numbness or foot changes.
  2. ExaminationChecking pulses in the legs and feet, listening for abnormal sounds over arteries, and looking at the skin of the legs and feet.
  3. Ankle-brachial indexOften the first test, comparing blood pressure at the ankle and arm.
  4. Risk factorsBlood pressure, cholesterol, blood sugar and smoking, because they drive both leg and heart risk.
  5. A planFurther imaging if needed, a walking program, medicines and, for some people, a procedure.

Testing

Tests used to evaluate leg circulation

Common PAD tests
TestWhat it shows
Ankle-brachial index (ABI)A painless comparison of ankle and arm blood pressure. A resting ABI under 0.90 suggests PAD; your clinician interprets your result in context.
Exercise ABIRepeats the ABI after walking when symptoms suggest PAD but the resting test is borderline.
Peripheral arterial ultrasound (Doppler)Locates narrowed areas and measures blood flow speed in the leg arteries.
CT or MR angiographyDetailed images of the arteries, usually when a procedure is being planned.
Catheter angiographyContrast X-ray inside the arteries, often done together with treatment.

Treatment

Treatment and management discussions

Walking and exercise therapy

A structured walking program, supervised or home-based, is one of the most effective ways to improve walking distance with claudication.

Protecting the heart and brain

Stopping smoking, controlling blood pressure, cholesterol and blood sugar, and medicines to reduce clot risk lower the chance of heart attack and stroke. Medicine choices depend on your other conditions and bleeding risk.

Foot care

Daily foot checks, good footwear and prompt care of any wound are especially important for people with diabetes.

Procedures

When symptoms limit daily life despite other treatment, or when blood flow is threatened, a peripheral vascular intervention such as angioplasty or stenting may be discussed. Bypass surgery by a vascular surgeon is an option for some people. Procedures have benefits and risks, and they are not the first step for everyone.

Your cardiologist

Who you will see

Headshot of Dr. M. Usman Khan, Houston cardiologist

Dr. M. Usman Khan, MD

Dr. Khan evaluates leg circulation problems, interprets vascular testing, and performs peripheral angiography and angioplasty when they are appropriate.

Read Dr. Khan’s full profile

Where care happens

Offices and where tests take place

Office visits take place at our three offices. ABI and vascular ultrasound may be done in the office or scheduled separately; angiography and interventions take place in a hospital or procedure setting. Our team will confirm the location.

Northwest Houston

17070 Red Oak Dr #405
Houston, TX 77090

Call (832) 432-1951
Office details and directions

Tomball

155 School St Suite 220
Tomball, TX 77375

Call (832) 304-2070
Office details and directions

Sugar Land / Greatwood

6534 Greatwood Parkway Unit A
Sugar Land, TX 77479
Also serves Richmond-area patients

Call (832) 645-8992
Office details and directions

Before you come

Preparing for your visit

  • A list of medicines and supplements
  • Prior ABI, ultrasound or angiography reports, and records of any leg procedures
  • A note of how far you can walk before symptoms start
  • Comfortable clothing that allows access to your legs and feet
  • Your insurance card and photo ID; send any required referral before the visit

See new patient information and the insurance plans we work with. Coverage depends on your specific plan, so please confirm with your insurer.

Questions

Common questions

Is leg pain when walking always PAD?

No. Nerve compression in the spine, arthritis and muscle problems can cause similar pain. The pattern of symptoms, the exam and an ABI help tell them apart.

Does PAD always need a procedure?

No. Many people improve with a walking program, quitting smoking and medicines. Procedures are considered when symptoms stay limiting or blood flow is threatened.

Why does PAD raise heart risk?

The same plaque process that narrows leg arteries often affects the heart and neck arteries too. Treating risk factors protects all of them.

Sources

References

  1. NHLBI. Peripheral Artery Disease: Diagnosis
  2. NHLBI. Facts About Peripheral Artery Disease (fact sheet)
  3. NHLBI. Atherosclerosis: Treatment (exercise therapy, angioplasty)

Prepared by the Epic Heart & Vascular Center editorial team. Clinical review by a practice physician is pending for this version. Last updated November 2026.

Next step

Request a leg circulation evaluation

Submitting the form sends a request. Our team will call you to confirm a time, the office and your insurance. For a suddenly cold, pale or painful leg, call 911.

Care is led by Dr. M. Usman Khan, MD, FACC, an interventional and general cardiologist. New patients can review patient information and the insurance plans we accept.

Heart & Vascular Care Close to Home

Book a visit with our board-certified cardiologist at any of our three offices. Our team will call you to confirm your time and insurance.

Houston (NW / Red Oak)
17070 Red Oak Dr #405, Houston, TX 77090
832-432-1951

Tomball
155 School St Ste 220, Tomball, TX 77375
832-304-2070

Sugar Land (Greatwood)
6534 Greatwood Pkwy Unit A, Sugar Land, TX 77479
832-645-8992

For a medical emergency, call 911.

Schedule an Appointment

Fill out the form and our team will contact you to confirm your visit.