Koven Technology, Inc.

Your Vascular Healthcare Partner

Peripheral Arterial Disease

About PAD

Peripheral Arterial Disease (PAD) occurs when blood flow through the arteries is decreased due to the build-up of plaque along the arterial walls. This narrowing of the arteries is referred to as atherosclerosis. PAD most commonly occurs in the legs, feet, and toes.

The CDC has estimated that approximately 6.5 million Americans are affected by PAD ¹. People who suffer from PAD have an increased risk for developing coronary artery disease and cerebrovascular disease, which can lead to heart attack and stroke. Additionally, if left untreated, PAD can lead to Critical Limb Ischemia (CLI).  CLI occurs when not enough blood is being delivered to the leg to sustain the tissue. Patients who suffer from CLI are at risk for amputation of the toes, feet, and legs.

Koven is dedicated to the early diagnosis and management of peripheral arterial disease (PAD).


We understand that early diagnosis of PAD means a higher probability for limb and digit survival. We provide a wide selection of vascular Dopplers that facilitate PAD diagnosis through the universally accepted standards of systolic blood pressure measurements & Doppler blood flow assessment. We also recommend and support the use of PPG toe pressures to assess PAD in patients with unsuspected lower extremity vascular disease and in diabetic patients, when vessel calcification may result in falsely elevated ankle pressures.

¹ Centers for Disease Control and Prevention: Division for Heart Disease and Stroke Prevention. Peripheral Arterial Disease (PAD) Fact Sheet. Retrieved from https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_pad.htm.

Symptoms of Peripheral Arterial Disease (PAD) may include, but are not limited to:

  • Intermittent claudication
  • Cold pallid limbs
  • Hair loss on legs or feet
  • Slow wound healing
  • Changes in toenails
  • Numbness or tingling in the toes, feet or legs

Risk Factors that may increase the likelihood of developing PAD:

  • Age
  • Smoking
  • Diabetes
  • Hypertension
  • High cholesterol (hyperlipidemia)
  • Family history
  • Obesity
Screening & Diagnosis

When screening for Peripheral Arterial Disease (PAD), begin by first taking a thorough patient history noting any risk factors and apparent symptoms. If the patient displays signs of possible PAD a screening exam should be performed.

Typically, an Ankle Brachial Index (ABI) is performed to screen for Peripheral Arterial Disease (PAD). An ABI uses a vascular ultrasound Doppler to assess the ratio of ankle pressure to highest arm pressure.

A PPG toe pressure and related Toe Brachial Index (TBI) uses an infrared photoplethysmograph (PPG) module to determine the small vessel vascular condition distal to the ankle. Toe pressures may be useful in cases of unsuspected vascular disease and in baseline diabetic foot assessment where falsely high ankle pressures can occur due to calcification.

Segmental Pressure studies are used to localize the site of atherosclerosis. A significant pressure difference between two adjacent cuff sites indicates a narrowing of the artery along that portion of the leg. Segmental Pressures are performed similar to an Ankle Brachial Index study, but with additional cuffs placed above and below the knee and optionally on the upper thigh.

Post Exercise Arterial Stress tests are used to identify and determine the severity of lower-limb obstructions by measuring the amount of time required for systolic pressures to return to baseline following induced stress.