Inclusion Criteria:  - History of stable intermittent claudication for 3 or more months, and an Ankle-brachial index test (ABI) <0.9 at rest. Symptomatic PAD (claudication or critical limb ischemia)  Exclusion Criteria:  - Limb threatening ischemia, including rest pain and/or gangrene; impending limb loss or chronic osteomyelitis. Lower extremity vascular surgery, angioplasty or lumbar sympathectomy within 3 months of enrollment; severe peripheral neuropathy or any condition other than PAD that limits walking such as unstable angina; history of significant left main or three vessel coronary artery disease (>70% stenosis, unprotected by grafts) or recent myocardial infarction (6 weeks); chest pain during treadmill exercise which appears before the onset of claudication, chronic renal failure with an eGRF<30; Type 1diabetes mellitus, a BMI>40, and a HbA1c>8.5%. Refusal to give or inability to give informed consent. Pregnancy (Self-reported).