Peripheral Arterial Disease (PAD) Treatment in Manhattan
Peripheral Arterial Disease (PAD) affects more than 18 million Americans, and is one of the leading—but most overlooked—causes of leg pain, ulcers, and preventable amputations. At Fox Vein and Vascular, we offer comprehensive, state-of-the-art evaluation and treatment of PAD using minimally invasive vascular techniques performed by David Fox, MD, FACS, RPVI a board-certified vascular surgeon with extensive experience in limb preservation.
Early diagnosis and treatment of PAD are critical. With proper care, PAD-related complications—including amputation—can often be prevented.
- Minimally invasive treatments
- Board-certified vascular surgeon
- No hospital stay
- Fast recovery
- Personalized care
What Is Peripheral Arterial Disease (PAD)?
PAD occurs when the arteries that supply blood to the legs become narrowed or blocked due to atherosclerotic plaque (cholesterol and calcium buildup). Reduced blood flow deprives the muscles, nerves, and skin of oxygen-rich blood. PAD is part of a systemic vascular condition.
- Heart attack
- Stroke
- Cardiovascular mortality
PAD may be mild, moderate, or severe—depending on the extent of arterial blockage.
Symptoms of Peripheral Arterial Disease
PAD is often silent early on. As blockages progress, patients may experience:
Early or Mild PAD
- Leg fatigue or heaviness
- Slower walking pace
- Leg cramping with activities such as walking or stair-climbing (claudication)
Moderate PAD
- Pain when walking short distances
- Pain when walking short distances
- Leg cramping with activities such as walking or stair-climbing (claudication)
Severe PAD / Critical Limb Ischemia (CLI)
- Leg fatigue or heaviness
- Ischemic rest pain (pain or numbness in toes or feet even when not walking)
- Pain worse at night or when lying down
- Numbness or burning in the feet
- Non-healing wounds or ulcers in the legs, feet and toes
- Darkening of toes or skin
- Gangrene
PAD may be mild, moderate, or severe—depending on the extent of arterial blockage.
Why Urgent Evaluation Is Critical
PAD is a progressive disease. As blockages worsen, tissues lack oxygen, causing deterioration that can rapidly lead to ulcers or infections.
- Prevent or reverse limb-threatening reductions in blood flow (ischemia)
- Restore blood flow
- Improve walking ability and quality of life
- Avoid major surgery or amputation
Dr. Fox provides both diagnosis and treatment in a modern, minimally-invasive outpatient setting.
How PAD Is Diagnosed at Fox Vein Care
Accurate diagnosis is essential for determining the right treatment path. Our diagnostic vascular laboratory provides:
Ankle-Brachial Index (ABI) Screening
A quick, non-invasive test comparing blood pressure in the arms and ankles.
Multilevel ABI/PVR
A more extensive non-invasive test measuring circulation in multiple levels in the legs, feet
Digital Studies
A non-invasive test that measures circulation in the toes
Duplex Ultrasound
Evaluates blood flow, blockage severity, and plaque characteristics producing real-time images of the circulation without x-rays
Advanced Arterial Imaging
In selected cases:
- CT angiography
- MR angiography
- Invasive angiography (gold standard)
Minimally Invasive Treatment Options for PAD
Evaluates blood flow, blockage severity, and plaque characteristics producing real-time images of the circulation without x-rays
Angiography
A precise imaging technique using contrast to map areas of blockage.
Balloon Angioplasty
A small balloon is inflated inside the blocked artery to widen it and restore blood flow.
Atherectomy
A specialized device removes plaque from the arterial wall to improve flow and reduce the likelihood of re-narrowing.
Stenting
A metal or polymeric (BTK stent) scaffold is placed inside the artery to keep it open long-term.
Specialized Limb Salvage Techniques
For severe PAD with ulcers or gangrene, targeted revascularization can salvage the limb and prevent amputation.
All procedures are performed by Dr. Fox using advanced imaging guidance in an outpatient setting when appropriate.
Wound Care for PAD/Venous-Related Ulcers
Patients with PAD may develop non-healing foot or toe wounds. Restoring circulation is only one facet of treatment—ongoing wound care is critical.
- Close monitoring
- Debridement when needed
- Infection prevention and treatment
- Nutritional assessment and treatment
- Coordination with podiatry and primary care
Healing can often be achieved once proper blood flow is reestablished.
Varicose Vein & Spider Vein Treatment Options
Preventing PAD
Although some risk factors are genetic or age-related, many causes of PAD are preventable or manageable:
- Control high blood pressure
- Keep cholesterol within healthy ranges
- Maintain regular physical activity
- Quit smoking – the #1 most important action (smoking increases PAD risk 2–6×)
- Maintain a healthy diet and weight
Dr. Fox provides guidance on optimizing vascular health both before and after treatment.
PAD Risk Factors
PAD becomes more common with age and in certain populations:
- Age 60+
- Diabetes
- Smoking
- High cholesterol
- High blood pressure
- Family history of vascular disease
- Higher incidence among African American and Hispanic populations
PAD affects men and women equally, although symptoms may differ.
A consultation with Dr. Fox—including diagnostic ultrasound and a review of imaging studies—is the best way to determine candidacy.
Why Choose Dr. Fox for PAD
Treatment in Manhattan?
Board-Certified Vascular Surgeon
Expertise in complex arterial disease and minimally invasive limb-salvage procedures.
Advanced In-Office Diagnostic Laboratory
Immediate, accurate testing for same-day diagnosis.
Minimally Invasive Treatment Philosophy
Most cases are treated without open surgery.
Personalized, Evidence-Based Care Plans
Every patient receives a tailored vascular strategy.
Commitment to Limb Preservation
Early detection and proper treatment reduce amputation rates.
Frequently Asked Questions
Is PAD dangerous?
Yes—left untreated, PAD can lead to severe pain, ulcers, infections, and possible amputation. It is also linked to heart attack and stroke risk.
Is PAD curable?
PAD is manageable. Treatments restore blood flow, reduce symptoms, and prevent progression.
Does PAD only affect older adults?
PAD becomes more common with age, but smoking and diabetes can cause it earlier.
Will I need surgery for PAD?
Most patients benefit from minimally invasive procedures like angioplasty or atherectomy instead of open surgery.
How soon will I notice improvement after treatment?
Many patients feel relief from rest pain and claudication immediately following revascularization.
David Fox, MD, FACS
- Double Board-Certified Vascular Surgeon
- Attending Vascular Surgeon, Lenox Hill Hospital
Dr. Fox has over two decades of experience diagnosing and treating venous and arterial conditions using the latest minimally invasive techniques. His approach is focused on precision, safety, and helping patients avoid major surgery whenever possible.
You don’t have to live with pain, swelling, or limited mobility.
Get a personalized evaluation and find out which treatment is right for you.
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