Stable blood flow is critical for the functioning of organs, as they rely heavily on the steady supply of oxygen to operate efficiently. Unfortunately, a significant number of people have unhealthy amounts of plaque in their arteries, which is a major hindrance to blood flow. As this plaque thickens, symptoms may appear in six distinct stages.
Peripheral artery disease typically describes problems with blood flow in the arteries of the lower legs.
The arterial disease is a key manifestation of atherosclerosis, which can develop over the course of decades.
An early diagnosis is favourable, as rapid initiation of lifestyle changes can make a significant difference in prognosis.
Writing in the journal Seminars in Interventional Radiology, researchers explained: “More than 90 percent of patients presenting with symptoms or signs suggestive of peripheral artery disease have atherosclerotic vascular disease.”
Symptoms, however, are scarce in the developmental stages of PAD, so understanding the gradient of symptoms can help doctors gauge the extent of vascular damage.
The Rutherford classification describes seven stages of peripheral artery disease:
Stage 0 – Asymptomatic
Stage 1 – Mild claudication
Stage 2 – Moderate claudication
Stage 3 – Severe claudication
Stage 4 – Rest pain
Stage 5 – Ischaemic ulceration not exceeding ulcers to the digits of the foot
Stage 6 – Severe ischaemic ulcers of frank gangrene.
The severity of intermittent claudication is generally described in terms of “claudication distance” based on walking in daily life.
People with severe claudication are generally unable to complete a standard five-minute treadmill walk.
These individuals often describe symptoms onset within minutes of walking that force them to stop, producing significant disability, according to Science Direct.
Functional testing in these individuals often reveals a broad range of impaired strength in the lower limbs that subsequently affects balance.
Science Direct states: “Functional decline over time in intermittent claudication is significant and is associated with the severity of PAD and other factors such as age, race and socioeconomic status.”
Rest pain, which occurs in the fourth stage of PAD, is especially noticeable during the night when the legs are raised up on the bed.
This diminishes the gravitation effects and sensory stimuli present by day, allowing patients to focus on their legs.
In the next stage, ischaemic ulcers or gangrene may emerge around the feet, ankles or legs, which may be dry or humid.
Foot ulcers are open sores and lesions that do not heal over long periods of time, causing swelling, burning and pain.
They are considered a major red flag for anyone with advanced PAD, as healing is unlikely, and may warrant an amputation.
How to prevent PAD
High cholesterol contributes to the formation in an insidious manner, but lifestyle interventions can offer results in as little as four weeks.
Bringing in more fibrous foods to the diet and exercising regularly can make significant changes to a person’s lipid profile.
If lipid levels remain stubbornly high, a doctor may consider prescribing statins as a more drastic control measure.