Understanding the Stages of Peripheral Arterial Disease

Peripheral Arterial Disease (PAD) is a common yet underdiagnosed condition that affects millions of Americans. It occurs when the arteries that supply blood to the limbs, most often the legs, become narrowed or blocked due to atherosclerosis. Left untreated, PAD can lead to serious complications, including ulcers, gangrene, or even limb amputation.

In this article, we’ll discuss the stages of PAD, the symptoms to watch for, how the disease is diagnosed, and how early treatment can make all the difference.

What Is Peripheral Arterial Disease (PAD)?

Peripheral Arterial Disease is a type of vascular disease that occurs when arteries outside the heart and brain, especially those supplying the legs, become narrowed by plaque build-up. This build-up, known as atherosclerosis, restricts blood flow and oxygen to the lower limbs, leading to pain and other complications.

PAD is more than just poor circulation; it is a serious condition that can reduce mobility, affect quality of life, and increase the risk of heart attack and stroke. Understanding PAD and its stages helps with early detection and better management outcomes.

The Four Stages of PAD

PAD progresses through four main stages. Recognizing the symptoms early can help prevent the disease from advancing to more severe and potentially life-threatening stages.

1. Asymptomatic PAD

In the earliest stage, many individuals do not experience any symptoms. However, damage is already occurring inside the arteries. Despite the lack of visible signs, blood flow to the legs is reduced, and the risk of complications is beginning to rise.

Who is at risk?
People with diabetes, smokers, individuals with high cholesterol or blood pressure, and those over age 60 should be especially cautious, even if they feel fine. Routine vascular screenings like the Ankle-Brachial Index (ABI) can help detect PAD before symptoms develop.

2. Claudication

Claudication is often the first noticeable symptom of PAD. It refers to leg pain or cramping during physical activity, such as walking or climbing stairs, that goes away with rest.

Symptoms of Claudication Include:

• Aching, cramping, or fatigue in the calves, thighs, or buttocks.
• Pain that occurs during activity and resolves with rest.
• Reduced walking distance before pain starts.

Claudication is not simply a sign of aging—it’s a warning that the arteries supplying your muscles are not delivering enough oxygen-rich blood.

3. Rest Pain

As PAD worsens, pain may no longer be limited to exercise. Rest pain occurs when the blood flow is so severely restricted that pain continues even when you're sitting or lying down, especially at night.

Signs of Rest Pain:

• Persistent burning or aching in the feet or toes.
• Pain relief only when the legs are hanging down, allowing gravity to assist blood flow.
• Trouble sleeping due to leg discomfort.

Rest pain signals that PAD has moved beyond a nuisance—it is now threatening your limb’s health and requires urgent attention.

4. Critical Limb Ischemia (CLI)

Critical Limb Ischemia is the most advanced and dangerous stage of PAD. It occurs when arteries are so blocked that non-healing wounds, ulcers, or even gangrene develop due to lack of oxygen to the tissue.

CLI Symptoms:

• Chronic rest pain.
• Open sores or leg ulcers that don’t heal.
• Skin that turns blue or black.
• Tissue death (gangrene), potentially requiring amputation.

CLI is a medical emergency. Without prompt treatment, patients face the possibility of limb loss or life-threatening infection.

Symptoms and Diagnosis of PAD

Being able to recognize the symptoms of PAD, especially early on, can be life-saving.

Common PAD Symptoms:

• Leg pain or cramping during walking (claudication).
• Numbness or weakness in the legs.
• Coldness in one leg or foot compared to the other.
• Slow or non-healing wounds on the toes, feet, or legs.
• Skin discoloration or shiny skin.
• Weak or absent pulse in the legs or feet.
• Poor nail or hair growth on the affected leg.

Risk Factors for PAD

PAD shares many risk factors with heart disease and stroke. If you have one or more of the following, you could be at risk for developing PAD:

• Smoking (current or past)
• Diabetes
• High cholesterol
• High blood pressure
• Obesity
• Age over 60
• Family history of vascular disease

Knowing your risk is the first step toward prevention or early diagnosis.

How to Prevent PAD

The good news is that PAD is largely preventable and manageable with lifestyle changes, especially when caught early.

Tips to Prevent PAD:

• Quit Smoking: Smoking is the single most significant risk factor. Stopping improves circulation and slows disease progression.
• Control Diabetes and Cholesterol: Keep blood sugar and cholesterol levels in check with proper diet, exercise, and medications if needed.
• Maintain a Healthy Weight: Excess weight increases strain on the cardiovascular system.
• Exercise Regularly: Moderate activities like walking help improve blood flow and reduce symptoms.
• Eat a Heart-Healthy Diet: Focus on whole grains, fruits, vegetables, and lean proteins.
• Monitor Blood Pressure: High blood pressure accelerates arterial damage.

PAD Treatment Options at South Valley Vascular

At South Valley Vascular, we understand that no two patients are alike. That’s why we offer a full range of personalized PAD treatments—from lifestyle modifications to advanced surgical procedures.

Treatment Options Include:

• Lifestyle Changes: Smoking cessation, exercise, and dietary improvements.
• Medications: To improve blood flow, lower cholesterol, and manage blood pressure or blood sugar.
• Minimally Invasive Procedures:
  
  • Angioplasty: A balloon is used to open narrowed arteries.
  • Stenting: A mesh tube is inserted to keep the artery open.
• Bypass Surgery: A healthy vein or synthetic graft is used to reroute blood flow around a blocked artery.
• Ankle-Brachial Index (ABI): Compares blood pressure in your ankle and arm to detect reduced blood flow.
• Vascular Ultrasound: A non-invasive imaging method that uses sound waves to visualize the arteries and detect blockages or narrowing.
• Angiography: Involves injecting contrast dye into the arteries and capturing X-ray images to locate and evaluate the extent of blockages.

Why Choose South Valley Vascular?

Since opening in 2005, South Valley Vascular has become a leading provider of vascular care across California’s South Valley. Founded by Dr. John Campbell in Visalia, the practice has grown to include multiple board-certified vascular surgeons and now operates offices in Visalia, Hanford, Porterville, and Fresno.

What Sets Us Apart:

• Expertise in Vascular Disease: Our surgeons specialize in treating complex PAD cases with compassion and precision.
• Advanced Diagnostics: We use cutting-edge imaging technology to detect PAD early.
• Comprehensive Care: From diagnosis through treatment and follow-up, our team is here every step of the way.
• Multiple Locations: With four locations across the South Valley, we make expert care convenient and accessible.

Take the Next Step Toward Better Vascular Health

If you're experiencing leg pain, have slow-healing wounds, or know you’re at risk for Peripheral Arterial Disease, don’t wait. Early diagnosis and treatment can prevent serious complications, including limb loss.

Contact South Valley Vascular Today

📍 Visalia – (559) 625-4118
📍 Hanford – (559) 825-6204
📍 Porterville – (559) 788-1022
📍 Fresno – (559) 746-9605

🔗 Book your appointment today!

Don’t Ignore the Signs—Your Legs May Be Telling You Something.

Schedule your consultation with South Valley Vascular today and take the first step toward healthier circulation.