If untreated, PAD can progress into advanced PAD, also known as CLI. Advanced PAD is a severe blockage in the arteries of the legs or feet that significantly reduces blood flow. At this stage, legs or feet may develop painful sores, ulcers and/or gangrene due to lack of oxygen. The pain may be severe and can last for hours—even while you’re at rest.

Advanced PAD

Advanced PAD is a serious condition that can cause tissue damage and may eventually lead to amputation. Additionally, the symptoms associated with advanced PAD, such as non-healing ulcers and gangrene, can lead to a lower quality of life and increased risk of death. The symptoms of advanced PAD can lead to amputation if action is not taken. For those with CLI, the outcomes are worse: statistics show that 26% of patients have had a major amputation in their first year. 14

Asymptomatic

No symptoms despite positive non-invasive vascular testing

Intermittent claudication

Fatigue, aching, or burning pain in the legs that is relieved by rest

Rest pain

Severe pain due to inadequate blood flow that occurs while at rest

Open Wounds/Gangrene

Open wounds, non-healing ulcers on feet along with resting leg pain. Dead black tissue (gangrene) can occur

Amputation

If blood flow cannot be restored, the affected toe, foot or limb may have to be amputated

Asymptomatic
Intermittent claudication
Rest pain
Open Wounds/Gangrene
Amputation

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No symptoms despite positive non-invasive vascular testing

Fatigue, aching, or burning pain in the legs that is relieved by rest

Severe pain due to inadequate blood flow that occurs while at rest

Open wounds, non-healing ulcers on feet along with resting leg pain. Dead black tissue (gangrene) can occur

If blood flow cannot be restored, the affected toe, foot or limb may have to be amputated

Rest Pain

A prominent symptom of advanced PAD is rest pain. This pain occurs while sleeping, laying down, or otherwise at rest. The pain may be severe enough to interrupt sleep.

Open Wounds/Gangrene

If you have advanced PAD, you have limited blood flow, which makes it harder for the body to heal itself. As a result, any wounds or ulcers you develop will likely be slow to heal or will remain open and vulnerable to infections that your body cannot fight off. Open wounds can contribute to the development of gangrene.

Gangrene is one of the most severe symptoms associated with advanced PAD and is potentially life threatening. Gangrene results from restricted blood flow in your toes, feet, and legs, killing cells and tissue. Gangrene can cause your skin to dry out, shrivel, and turn colors. In advanced PAD, gangrene can lead to amputation.23

Amputation

Peripheral artery disease (PAD) can lead to serious complications, including amputation, especially when blood flow to the legs is severely reduced. Infections are a major reason for amputations, and even small amputations can increase the risk of future heart and limb problems.

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