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 40% of patients will have amputation and 20% will die within 6 months.14

Asymptomatic

No symptoms despite positive non-invasive vascular testing

Intermittent Pain

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 be amputated

Asymptomatic
Intermittent Pain
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 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. As opposed to intermittent pain, rest pain can last anywhere from minutes to multiple hours at a time.1

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.

Amputation

If you have been told you need an amputation due to advanced PAD, you likely have a blockage in one of your arteries which is preventing blood from reaching a part of your body, such as your feet or toes.

Amputation is a potential outcome of advanced PAD. However, many lower limb amputations resulting from advanced PAD and other diabetes-related complications may be preventable. It’s important to get a second opinion about your case if you’ve been told that you need an amputation. Saving your limb may be achievable with endovascular treatment options. The decision to not get an amputation comes with associated risks. In some cases, amputation may be the best solution.

Patient Stories

With millions diagnosed each year, there’s a community of PAD patients looking to tell their stories. Hear from real patients at various stages of their PAD journey below.