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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.

PAD Older Woman Massaging Leg Cramp

Four Stages of Peripheral Artery Disease

Peripheral arterial disease occurs when the arteries that supply blood and oxygen to the legs and feet become clogged or blocked by plaque buildup, so it makes sense that the disease would occur in stages depending on the severity of the blockage. PAD can build up over a person’s lifetime, gradually worsening over time as plaque continues to form in the arteries. The earlier the disease can be identified, the sooner treatment can begin and symptoms can be addressed. Learn more about the four stages of PAD and how they often present below.

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.

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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)
  • Angiography
  • 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:

  • Angioplasty
  • Atherectomy
  • 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.

Our Vascular Centers in NY & NJ

Patients in and around New York and New Jersey have convenient access to our vascular centers. Each of our locations is equipped with the latest minimally-invasive, image-guided technology so that we can provide patients with the best possible outpatient care for all manner of vascular concerns.

Brooklyn, NY
71 Carroll Street
Brooklyn, NY 11231
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Queens, NY
28-18 31st Street
Queens, NY 11102
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Harlem, NY
505 East 116th Street
Harlem, NY 10029
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West Orange, NJ
347 Mount Pleasant Avenue
West Orange, NJ 07052
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What Our Patients Are Saying

Excellent, professional, organized and efficient all best describes the service here.
Delsi Cunningham
Delsi Cunningham
17:28 05 Apr 24
Very nice and friendly staff.I was so nervous, they all made me feel relaxed and comfortable.They explained everything to me step by step.
Keith Dickens
Keith Dickens
13:10 02 Apr 24
Excelente servicio es lo mejor que me a pasado gracias a sus buenos tratamiento ya no tengo dolor
The staff are the best. Very elated,with the exceptional care,professionalism, and genuine concern, displayed by all the staff.
Constance Sidberry
Constance Sidberry
03:50 17 Mar 24
First Impressions are lasting impressions! First, the staff are phenomenal! How is it possible that each and every one of them are incredibly kind, caring, professional, personable and treat you like you are THE most important person in the world!? Well, meet this team for an experience that will make you feel valued as a person, not just as a patient. In walks this amazing Doctor and now you understand why his team are the way they are! They regard each other with the utmost respect, and kindness, and they communicate with each other like family. And as a new patient, I had the honor and pleasure to experience excellence in patient care and concern. I am so very grateful to have found a Doctor who is in my opinion perfect with a team who are exceptional! I’m excited for my next visit, honestly! I write this with a great big Smile on my face!
CC
CC
20:47 02 Mar 24
I felt very comfortable with him. Excellent bedside manner, proper teaching , and knowledgeable. I highly recommend him!
Jamel Jackson
Jamel Jackson
14:07 27 Feb 24
Yes it was a good place
Carmen Diaz
Carmen Diaz
14:22 20 Feb 24
The absolute BEST Dr!! Detailed, caring & kind! The best medical procedure I’ve ever had from consultation to post procedure, perfect! 10s all around 👏🏽👍🏽👍🏽 many thank yous🙏🏾
Josi W
Josi W
22:04 12 Jan 24
Is good to be with friendly and professional staff at doctor’s offices like this one.
Dr. Joseph Sham and the entire Team were very professional, knowledgeable, informative and had incredible patience with me by answering all my questions and concerns. Great Team…Thank you all! 👍
Marion
Marion
22:17 27 Dec 23
I was treated very well. The staff was very professional and made me feel comfortable. Looking forward to my next visit.
Stephen Lapinsky
Stephen Lapinsky
20:17 20 Dec 23
This experience was great I’m so happy with everything
stephanie suazo
stephanie suazo
22:53 13 Dec 23
Love this Dr and staff. They are all kind courteous and professional with excellent medical care. I would highly recommend them to anyone in need.
Sybil Wilkins
Sybil Wilkins
21:58 28 Nov 23
I love this place stuff is helpful an they all were nice. I had a wonderful experience Dr Shams was great.
Victoria Pacheco
Victoria Pacheco
22:07 17 Nov 23
Professional services
Ricky Mo
Ricky Mo
22:14 15 Nov 23
I like the doctor they were kind of pretty thorough he says that he could help me he found out the filter in my abdomen from the surgery I had in 1996 has been clogging my blood flow for 25 years and that’s causing the swelling at every other doctor told me was lymphedema it was not lymphedema it caused the lymphedema because no other doctor took the time or care enough to find out the reason for my leg swelling this doctor was the only one who finally found out and he’s going to see if you could put a stent inside the filter to open it up and and stop my legs from swelling hopefully this will all go good it hasn’t happened yet but I’ll keep you posted thankful for this docto I just pray and hope that it works otherwise I like the doctor very much
Mitchell Dedios
Mitchell Dedios
21:01 27 Oct 23
Excellent service , good customer service and friendly staff. Thanks
Raysa Polanco
Raysa Polanco
20:54 27 Oct 23
You may likely have to wait. Avoid anxiety and frustration. Schedule extra time for the visit. Allow for personal attention to your care needs once in the examination room. Friendly, nice staff and doctor puts you at ease. Bottom line: worth the wait!
Sisle
Sisle
21:49 26 Oct 23
Excellent service and staff i’ll let you feel relaxing and comfortable
kadine campbell
kadine campbell
21:01 23 Oct 23
Sheer perfection. The care and expertise and teamwork are the best I have ever experienced. I’m a former nurse and I recognize and give a shout out to the best!!!!
Barbara Murray
Barbara Murray
20:49 10 Oct 23
I was given good advice about my blood circulation
Gary Jackson
Gary Jackson
17:04 08 Oct 23
Dr. Shams office is amazing. Whitney and Angela were AMAZING. Great sense of humor. Staff is WONDERFUL.
Sara Correa
Sara Correa
21:13 18 Sep 23
Nice office, personnel friendly, & caring, good informative information concerning my care.
Loretta Johnson
Loretta Johnson
21:26 22 Aug 23
Really like this doctor, talks in your language, just over all regular nice person.
Linda Thoomey
Linda Thoomey
22:03 21 Jul 23
I’m very satisfied of my visit for the first time, everyone was concerned about me, and Dr David was very patient to listen to my long health stories, after that He gave me good explanation for my problem, that was great 👍
Claude Jean Pierre
Claude Jean Pierre
22:38 18 Jul 23
Follow up to a procedure. Dr Mobley and his staff are great and always helpful
DanLiza Diehl
DanLiza Diehl
21:25 10 Jul 23
David monkey,MD and the grupo are excellent very kind and helpful.i will return to them.the attention.its very satisfied.thank u ..
Luis Sarria
Luis Sarria
12:16 29 Jun 23
I had a good experience with my procedure and Dr. Mobley’s follow-up calls are great. I’ve never had a doctor who has been so concerned about following up after a procedure to see how I’m doing and if there are any post-procedure problems I may have experienced (which there aren’t). I’d highly recommend Dr. Mobley.
Hey Beej
Hey Beej
16:42 23 Jun 23
Dr Mobley was so helpful, informative and made me feel secure in making my future medical plan. Supportive and kind. Highly recommended.
Amanda L Browder
Amanda L Browder
15:57 23 Jun 23
Doctor was very thorough. Explaining what the procedure is all about. Tell me what I could realistically expect. Couldn’t have asked for a better consultation. Highly recommended if you have a prostate issue
John Buric
John Buric
16:26 15 Jun 23
I was very pleased and satisfied on how Dr. David Mobley examined me and explained everything on what I need to know regarding my condition. He’s very professional and knowledgeable in all aspects of his profession. I would highly recommend him to my other friends!
Celine Parcon
Celine Parcon
23:16 07 Jun 23
Dr Shams was very attentive and explained everything in detail. The staff was very nice, the staff/nurse were all so very helpful, It was a Monday morning and I didn’t expect such happy staff.
Stacy Lebeau
Stacy Lebeau
21:22 06 Jun 23
He puts his patients before himself, returning calls and e-mails quickly. Not only is he kind and considerate, he is an excellent physician. I had to have a procedure that requires me to be awake, and he talked me through it and kept me at ease. If I could give him more stars, I would.
Super friendly, tentative, once in the procedure rm the sx staff made you feel comfortable, easy,+ answered all questions. David mobley, MD answered all my questions, very informative, caring. I felt confident in his care
Thais Bini
Thais Bini
21:22 30 May 23
Great doctor. Everyone is so kind and caring. Great place to go
Joan Jurica
Joan Jurica
14:46 30 May 23
Good service!
Veronika Shopina
Veronika Shopina
21:09 24 May 23
There is a friendly atmosphere, fast medical attention and an advanced medical equipment !!!The Staff is very knowledgeable and the best care possibly !!!100 % Satisfied !!!
Cruz Figueroa
Cruz Figueroa
03:06 08 May 23
Whole staff was very friendly and professional. I feel confident that I came to the right place for treatment.
Rudy Padilla
Rudy Padilla
02:08 13 Apr 23
The best in Astoria I recommend Dr mobley and staff 100 percent
michaela1951
michaela1951
21:25 30 Mar 23
Knowledgeable , experienced, great bed side manners
mohamed hamed
mohamed hamed
10:09 30 Mar 23
I am pleased w/my experience @ endovascular. I hope they can save my foot.
Margo A Williams
Margo A Williams
19:19 29 Mar 23
This has been the best medical experience I’ve had in over thirty years. I was nervous to have a procedure after only knowing about my condition a year ago. They made this process so easy for me that I’m in shock that I had no pain, no discomfort thanks to an excellent doctor and professional staff! Thank you all and best of luck to your practice.
Stacey Marius
Stacey Marius
14:16 29 Mar 23
The doctor was very nice and professional. He explained the tests that I need and why I need them.
Judith AndersonNeal
Judith AndersonNeal
22:12 27 Mar 23
This was the best experience I have had in such a long time and I have had quite a few procedures in the past both in patient and out including the procedure I was currently present for. No other surgeon has been so kind, transparent, and gentle. Not only did he personally come out beforehand to provide me with education on my procedure, but he talked me through every step of the way and made me feel so comfortable and relaxed. Not to mention his amazing staff! Despite being extremely nervous they kept me smiling and laughing throughout the whole process. 10/10 would recommend. Thank you so much guys!!
Riah L.
Riah L.
13:49 22 Mar 23
Excellent bedside manners and the procedure was a breeze.
sen-pei hsia
sen-pei hsia
18:26 20 Mar 23
Los mejores/ the best💖🙏
Ruthy Ochoa
Ruthy Ochoa
04:17 03 Mar 23
Excellent, Patience, don’t Rush you to be finished. The Doctor explains everything and answers your questions. I would Recommend Dr.Sham service anytime, they are. Great!
Debra Farmer
Debra Farmer
00:16 01 Mar 23
I went with my mom who just had a hip surgery. The whole team was very caring, nice and very professional. I did appreciate that the surgeon took the time to explain to me what was wrong with my mom’s arm and what he did to fix it.
mouna khalyat
mouna khalyat
14:37 24 Feb 23
Very good and very responsive.
James Young
James Young
19:33 22 Feb 23
Although I didn’t meet with the doctor, the receptionist, assistant and nurse were great.
Theresa Gaines
Theresa Gaines
13:25 13 Feb 23
Every thing and the process are being done properly ..Terissa you are very Carey ..thank you so much every body are very polite and very professional.. Thank you so much to Dr.Mobley..God blessed you all .🙏🙏🙏👍
Remigio Ruda
Remigio Ruda
03:28 31 Jan 23
Very knowledgeable, personable and professional. I came to Dr. Mobley to correct another surgeons work and I was pleased with the outcome. There is a Hispanic woman that runs things in the O.R.She is great! The whole staff is wonderful and caring.Highly recommend
Lakesha Kingdom
Lakesha Kingdom
15:57 17 Jan 23
I had a wonderful PA take care of me, & the nurses were very sweet. I was happy with my visit
Aurora Anello
Aurora Anello
19:20 10 Jan 23
Everything always goes well.staff are very caring.
Lillian Rodriguez
Lillian Rodriguez
19:00 11 Dec 22
Excellent Doctor he explains the procedure process so that it is understandable and comfortable for the patient!
T. J.
T. J.
14:48 06 Dec 21
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