How Many Stages of PAD Are There?
Peripheral arterial disease (PAD) occurs in four stages. Each stage has different characteristics and can affect the body in different ways, making it crucial for patients to be informed about what to look out for if they have potential symptoms of PAD. PAD can lead to major issues if left untreated, and proper diagnosis and medical care are key to avoiding potential amputation and other complications of this condition. At American Endovascular, our vascular specialists provide comprehensive care for patients with PAD, helping them to live healthier and more comfortable lives.
Stage 1: Asymptomatic
The first stage of PAD, also known as asymptomatic PAD, often goes undetected. At this point, patients have not begun to experience symptoms of the condition, so they may be completely unaware that plaque has started to build up in the arteries. At this stage, PAD is often detected via a cardiovascular checkup, through tests for blood pressure and cholesterol.
If you think you may be at risk for PAD (which is often the case for those with high cholesterol, high blood pressure, diabetes, or those who smoke), a vascular specialist can run the proper tests to determine if there is plaque in your arteries. Detecting PAD in the earliest stage allows you and your doctor to take proactive steps to prevent the buildup from worsening. Risk reduction efforts introduced at this stage may include improved diet and exercise, quitting smoking, and other lifestyle changes.
Stage 2: Claudication
The second stage of PAD is called claudication. At this stage, the arteries have begun to more significantly narrow and harden, resulting in uncomfortable symptoms. The core symptom of this stage is pain and weakness in the legs, feet, or calves when walking or engaging in physical activity. The pain often disappears during rest. This is because when you are walking or using your legs, they need more blood flow and oxygen than when you are resting.
During physical activity, the muscles are not able to get the nutrients they need because the arteries may be narrowed or partially blocked. Pain during the claudication stage most often occurs in the calves and can even result in a limp during physical activity. Treatment during this stage of peripheral artery disease is focused on decreasing or eliminating discomfort and preventing the arteries from narrowing further.
Stage 3: Critical Limb Ischemia
The last two stages of PAD involve ischemia – the reduction of blood flow to an area of the body. Pain during this stage worsens to affect patients even at rest and throughout the night, rather than just during exercise. Because blood is not able to properly flow to the extremities and aid with healing, skin sores, and ulcers may begin to appear.
Critical limb ischemia is considered to be a chronic condition that requires maintenance and treatment so patients can avoid serious complications, including amputation, stroke, heart attack, and even death. This stage of peripheral artery disease is often underdiagnosed and undertreated, but at American Endovascular, we work with patients in the Critical Limb Ischemia stage of PAD and provide treatment options to minimize the risk of future complications.
Stage 4: Acute Limb Ischemia
Acute Limb Ischemia (ALI)is a serious medical emergency and needs to be addressed as soon as possible. This complication of PAD can be seen as something similar to a heart attack or stroke. When PAD worsens enough to lead to ALI, blood flow to the limbs suddenly decreases, causing severe pain and tissue damage. The limb begins to rapidly deteriorate – patients will experience pain, tingling, loss of pulse, coldness, and potential paralysis.
Without immediate care, Acute Limb Ischemia carries a very high likelihood of amputation of the affected limb. The limb may experience irreversible muscular and nerve damage even if amputation can be avoided. Immediate intervention and treatment by a vascular specialist is crucial in minimizing the effects of this PAD complication.
How is PAD Diagnosed?
Early diagnosis of PAD is the ultimate goal of our vascular specialists at American Endovascular, because the sooner the condition is identified, the sooner treatments can begin to lower the risk of future complications, and even potentially reverse the condition. When you come to see us, we will review your medical history and assess your risk factors for vascular issues. Several non-invasive tests are also used to aid in the diagnosis of PAD.
- Ankle-Brachial Index (ABI)
- CT Angiography
- Blood Tests
- Duplex Ultrasonography
- Magnetic Resonance Angiography (MRA)
Treatment for PAD
At American Endovascular, we offer patients access to a variety of treatment methods for peripheral artery disease. Our minimally-invasive, image-guided procedures have the ultimate goal of restoring blood flow and getting patients on the road to a healthier life. Our physicians will inform you of the treatment options best suited to your stage of PAD and your unique medical situation, and may recommend the following:
- Stent Placement
- Amputation Prevention & Limb Preservation Techniques
Our Vascular Specialists
At American Endovascular, we are proud to offer care from our affiliated vascular specialists in NJ and NY who are considered the “best of the best” in endovascular care. The members of our team strive to stay up to date on the latest developments in treatments for PAD, and are considered innovators in vascular and interventional radiology. When you visit American Endovascular, you will have access to compassionate care every step of the way.
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