More than 400 amputations happen in the U.S. daily. Not from gun violence, shark attacks, or car crashes, but from a disease that is easily diagnosed, preventable, and treatable, if caught early. Peripheral artery disease, or PAD, is a circulation problem in which narrowed arteries reduce blood flow to the limbs, most often the legs. More than 200 million people suffer from PAD, yet many aren’t even aware they have it until it’s too late. Symptoms can be subtle and easy to dismiss like persistent leg pain and walking difficulty.
As a physician, I’m used to analyzing data and statistics to form treatment plans and share information with patients. As a niece of two people represented in this data set; these numbers aren’t just statistics on a page, they’re personal. My aunt and uncle represent two of the 400 people who experience a PAD-related amputation each day. I watched as they began to struggle to walk, witnessed their transition from crutches to wheelchairs, and saw how they grappled with the loss of toes, then parts of their feet and, ultimately, the complete loss of their limbs. It was heartbreaking to witness as a child, but devastating to look back on now that I know their suffering could have been mitigated or even prevented with earlier detection, diagnosis, and specialized care. That knowledge has fueled my passion for raising awareness of PAD because what you don’t know can cost you not just your mobility, but your independence and even your life.
From high-profile people like President Donald Trump, former NFL star Deion Sanders, and NBA player Zach Wheeler to the everyday American, vascular conditions affect people in different ways; some experience leg pain when walking, while others have no symptoms at all. Because these conditions can present so differently, it is critical to understand who is most at risk. Vascular disease disproportionately impacts people 60 years and older, with a growing aging population. The time is now to not ignore symptoms and seek treatment. From swollen ankles to discolored toes. No symptom should go unrecognized. PAD is one of the most recognizable diseases because of the severity of the outcomes like amputations. We need to take the necessary steps to avoid this unfortunately well-known consequence, and part of that begins with early recognition for high-risk individuals. Common risk factors of PAD include smoking, diabetes, high blood pressure, high cholesterol, and a family history of vascular disease. These risk factors are common, but a recent survey conducted by the Society for Vascular Surgery revealed nearly two-thirds (63 percent) of Americans never had a conversation about vascular health.
One of the biggest challenges I face as a vascular surgeon is that PAD is widely unknown and misunderstood. Many patients think leg pain or numbness is simply a part of aging. Others don’t realize that non-healing wounds on the feet or difficulty walking could signal serious vascular disease. Primary care providers are often the very first line of defense when it comes to spotting the warning signs of vascular disease. That puts them in a powerful position to change lives, sometimes even save them, by catching problems early and helping patients avoid devastating complications. But here’s the challenge: even though we all recognize how serious vascular disease is, a recent survey found that 80 percent of primary care providers don’t feel confident in recognizing and diagnosing it. That gap matters, because behind every swollen ankle, every cramp when walking, and every discolored toe is a patient whose future may depend on timely care.
That’s why I urge primary care providers to lean into this opportunity: trust your instincts, stay alert to the subtle signs, and don’t hesitate to refer patients to vascular specialists. We are here, trained to treat PAD and the full spectrum of vascular conditions, ready to partner with you so patients don’t fall through the cracks. Vascular surgeons are uniquely trained to diagnose, manage, and treat vascular diseases like PAD throughout a lifetime. We can combine lifestyle changes, medications, minimally invasive procedures, and open surgeries to improve blood flow and prevent serious consequences like stroke, heart attack, and amputation. PAD isn’t just about poor circulation in the legs; it can be a red flag for broader vascular disease that also threatens the heart and brain. When patients see a vascular specialist, they aren’t just protecting their limbs; they’re protecting their lives.
When it comes to PAD, knowledge is power. My goal is always to partner with patients and their loved ones. Family and caregivers play a crucial role: intaking the abundance of medical information, helping track symptoms, supporting lifestyle changes, ensuring medications are taken, and advocating for timely care. Through family participation, awareness of vascular diseases like PAD can also increase within a community by simply having a conversation. If you or someone you love has risk factors for PAD, don’t wait for symptoms to become severe. Ask your doctor about screening, and if you’re concerned, request a referral to a vascular specialist. PAD doesn’t have to lead to amputation. Awareness, early detection, and specialized care can change the trajectory entirely. If you have diabetes, smoke, or have a family history of vascular disease, be proactive: get screened, ask questions, and don’t ignore symptoms like leg pain, numbness, or wounds that won’t heal.
My family’s story could have had a different ending with earlier recognition and intervention. That’s why I’m determined to make sure others don’t face the same loss. With education, empowered patients, and the right care, we can prevent amputations, protect independence, and save lives. PAD is serious, but it’s not hopeless. You have a role to play, and I have a role to play. Together, by closing the awareness gap, we can keep more people on their feet and living the full, active lives they deserve.
Xzabia Caliste is a board-certified vascular surgeon at Albany Med Health System and an associate professor of surgery at Albany Medical College. She is the former section chief of vascular surgery at the Albany Stratton VA and is RPVI certified, with training in both open surgical and endovascular techniques.
Dr. Caliste serves as an Ambassador for the Society for Vascular Surgery Highway to Health Campaign, advancing its mission to improve education and access to care in Black and Brown communities. She completed her vascular surgery residency in 2016 at the University of Rochester Medical Center, following her graduation from Georgetown University School of Medicine and Williams College. She also trained as a research fellow at Washington Hospital Center in Washington, D.C., and was awarded the 2013 American Venous Forum BSN-Jobst Research Fellowship Award for Outstanding Research.
For more information, visit YourVascularHealth.org or connect on LinkedIn.
