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What Are The Stages Of Peripheral Artery Disease & What Organs Are Affected By It?

Periphery artery disease is also known as a peripheral vascular disease, a disorder in which the plaque builds in the arteries and result in an abnormal narrowing of arteries. This eventually blocks the flow of blood that is transmitted to the head, organs, and limbs leading to chronic atherosclerotic disease of the lower extremities.

The multitude of presentations of this condition resulted in several classification schemes throughout medical science. This is often dependent on the disease stage of the patient and the treatment suggested based on their age and health condition.

What Are The Stages Of Peripheral Artery Disease?

Nearly a large population of peripheral artery disease patients is diagnosed for this condition through the ankle-brachial index (ABI) test. Since peripheral artery disease is asymptomatic, it is often difficult to identify the condition however ABI test scans for the functional impairment. The severity of the condition is quantified based on the ABI measurement.

Although ABI doesn’t provide a full picture of the disease severity, yet it produces a numerical value that helps perform the classification of stages.1,2

Classification of stages of peripheral artery disease is based on the two strategies: the Rutherford and the Fontaine

Asymptomatic Stage (Stage 0): This stage is asymptomatic meaning there are no symptoms. Nearly 8.5 million Americans are affected with peripheral artery disease however they don’t show any symptoms. This is proven by many professors of cardiac medicine saying that half of their patients show no symptoms. They don’t experience pain nor cramping. They can just realize that their organs are limiting them to perform normal movements.

Mild To Moderate Claudication (Stage 1 & 2): The initial symptoms of peripheral artery disease are pain and cramps in the calf muscle and the buttocks. You may feel the stress and pain when lifting groceries and climbing up in the stairs. Leg pain, long time to heal foot and leg sores, gangrene, erectile dysfunctions are some of the symptoms identified in this stage

Severe Claudication (Stage 3): Most pain of the claudication occurs when you stretch your muscles during exercises. This is due to too little blood flow to the organs. You can improve your symptoms and even several patients have yielded good results when the clot was removed, or a stent was placed to remove the clot and open the arteries.

Rest Pain (Stage 4)- Pain at rest is an indication of an advanced stage of peripheral artery disease. This shows there is a significant blockage in the arteries of the lower extremities.

Ischemic Ulceration (Stage 5 & 6)- Also known as arterial insufficiency ulcers occurs mostly in the lateral surfaces of the ankle. During this stage, the arteries are clogged preventing healthy blood supply flowing to the legs. People with high BP, high cholesterol levels, preconditions such as chronic kidney disease, smokers are often in this stage of peripheral artery disease.3

What Are The Organs Affected By Peripheral Artery Disease?

Ten million Americans suffer from peripheral artery disorder and experience hardening of the arteries. Peripheral artery disease, in general, leads to narrowing and stiffening of blood vessels and organs. The organs that are most affected with this condition are legs, brain, and kidney since they don’t get enough blood supply.

However, in patients with other conditions, peripheral artery disease can affect intestines and other structures of the arm resulting in decreased function. In advanced stages, it gets worse and the organs lose their complete functionality and eventually dies.4


  1. “Treatment Strategies for Patients with Peripheral Artery Disease (PAD).” Effective Health Care Program, 31 Jan. 2012, effectivehealthcare.ahrq.gov/products/peripheral-artery-disease-treatment/research-protocol.
  2. “The Early Stages of Peripheral Artery Disease.” Heart Insight Mag, heartinsight.heart.org/Fall-2018/The-Early-Stages-of-Peripheral-Artery-Disease/.
  3. Hardman, Rulon L, et al. “Overview of Classification Systems in Peripheral Artery Disease.” Seminars in Interventional Radiology, Thieme Medical Publishers, Dec. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4232437/.
  4. “Peripheral Vascular Disease (PVD), Peripheral Artery Disease (PAD): ColumbiaDoctors – New York.” ColumbiaDoctors, 21 Mar. 2018, www.columbiadoctors.org/condition/peripheral-vascular-disease-pvd-peripheral-artery-disease-pad.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 27, 2020

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