Peripheral vascular disease (PVD), or peripheral artery disease, is caused by the same atherosclerotic plaque that causes coronary artery disease. Frequently, atherosclerosis is not confined to one artery, but may involve arteries in other areas as well. Some of the commonly affected peripheral areas are the arteries in the legs, arms, kidneys and neck. Some patients may have both coronary artery disease and peripheral vascular disease.
As the internal lining of the artery thickens from the atherosclerotic plaque, the blood vessel becomes increasingly constricted and blood flow diminishes. Therefore, the symptoms you may experience depend on what artery is affected and how severely the blood flow is reduced.
Some of the symptoms you may experience in the affected areas are:
- Claudication (dull, cramping pain in hips, thighs or calf muscle)
- Buttock pain
- Numbness or tingling in leg, foot or toes
- Changes in skin color (pale, bluish or reddish discoloration)
- Changes in skin temperature, coolness
- Infection/sores that do not heal
- Ulceration or gangrene
- Uncontrolled hypertension (high blood pressure)
- Renal failure
Clinical studies have identified factors that increase the risk of peripheral vascular disease. Some of these factors cannot be changed while others can be managed to greatly reduce your risk of the disease. They are as follows:
- Diabetes: PVD is not uncommon among individuals with diabetes. This correlation is due to complications of the disease that may cause damage to the large and small blood vessels of the legs and feet.
- Smoking: The risk of PVD dramatically increases in smokers. When a person stops smoking, regardless of how much he or she may have smoked in the past, their risk of peripheral vascular disease rapidly declines.
- Any of the following risk factors may also increase your chance of developing peripheral vascular disease:
- Obesity (being overweight)
- High blood pressure
- A family history of the disease
- Lack of exercise
- Coronary artery disease
- Age greater than 65
- Hyperlipidemia (high cholesterol)
If your doctor suspects that you have peripheral vascular disease or if you have symptoms of the disease, several tests are performed to diagnosis it. Such diagnostic tests include:
- Ankle brachial index (ABI)
- Ultrasound doppler test
Many treatments can be used to improve blood flow through the peripheral arteries. The latest interventions for treating peripheral vascular disease can bring relief and are less invasive than surgery. Most procedures can be done as an outpatient procedure, and patients enjoy an early return to most normal activities. Techniques available to you include:
- Angioplasty and Stents
- Atherectomy – a minimally invasive interventional procedure that involves the excision and removal of blockages by catheters with miniature cutting systems
All of these techniques treat the buildup of plaque by either removing it, compressing it or displacing it. During these procedures, the physician will periodically inject a contrast dye and take X-ray pictures to determine whether or not the artery is sufficiently open. If the blockage is extremely long or has become very hard and calcified with time, it may be resistant to any of these interventions. In these cases, surgery may be required to bypass the problem area.
Noninvasive interventions may also be used to treat PVD. These interventions include: