Choosing Wisely

Treating Blocked Leg Arteries

When you need a procedure—and when you don’t

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The arteries in your legs and feet can get blocked, just like the arteries in your heart. When this happens, less blood flows to your legs. This is called peripheral artery disease (PAD).

Occasionally, if your leg arteries are badly blocked, you may develop foot pain while resting or a sore that won’t heal. In this case, you may need a proce­dure to remove the blockages. But usually, people with PAD do not need a procedure. Here’s why:

A procedure only helps for severe symptoms. 

If PAD causes severe leg pain when walking, you may stop doing that and other activities. Surgery to bypass the blockage can relieve these symptoms.  So can another procedure known as angioplasty.

Most people do not have symptoms.

For most people, PAD does not cause symptoms. Those who do develop symptoms might get a heavy, tired feeling or cramping in the legs while walking that only goes away when they stop walking. Taking medicine and walking more can actually reduce your symptoms and help keep PAD from getting worse.

Some doctors mistakenly recommend having surgery or angioplasty even if you do not have symptoms. However, this does not make people with PAD feel better or prevent future leg problems. Most people with PAD never develop problems that need surgery or angioplasty. This is because they do not have symptoms or because medicine and exercise work well enough to treat the pain and allow a normal lifestyle.

There are safe and simple ways to keep PAD from getting worse.

To control PAD, you should stop smoking and walk every day. And you should also work with your doctor to control other risk factors, such as diabetes, high blood pressure, and high cholesterol.

Even if you have symptoms, you may be better off not having a procedure. Studies show that walking every day can relieve symptoms just as well as angioplasty, in some cases.

Surgery and angioplasty have risks, and it takes time to get better.

Bypass surgery on your legs has all the dangers of major surgery. It takes two to three weeks for the wound to heal. Risks include infection, bleeding from the wound, and complications from anesthe­sia, such as trouble breathing or pneumonia. And about three out of 100 people who have bypass surgery have a heart attack or die.

Angioplasty is not as hard on your body as surgery, and the recovery is faster. But stents may not provide a lasting treatment and the original symptoms can come back within a year. Rarely, when a stent is being inserted, dangerous bleeding may happen and the stent may come apart.

Both procedures can, in rare cases, cause a partly blocked artery to close up completely. Then you may need an emergency procedure. If the procedure cannot be done right away, your leg may have to be amputated.

Surgery and angioplasty cost a lot. 

Surgery or angioplasty, including your hospital stay, can cost from $13,000 to more than $23,000.

When do you need a procedure for PAD?

You and your doctor should consider surgery or angioplasty if:

  • Your symptoms are severe enough to limit your lifestyle or your ability to work.
  • Simpler treatments, such as exercise and medicine, have not helped.

See your doctor right away to be evaluated for a procedure if you have any of these signs:

  • Foot pain when you’re resting, especially at night.
  • Sores on your toes or feet that do not heal.
  • A toe that looks blue or black and may hurt.


Advice from Consumer Reports

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2013 Consumer Reports. Developed in cooperation with the American Orthopaedic Foot and Ankle Society for Choosing Wisely, a project of the ABIM Foundation. To learn more about the sources used in this report and terms and conditions of use, please visit