Peripheral Vascular Disease
What is Peripheral Vascular Disease?
Peripheral vascular disease (PVD) develops as plaque builds up on the inside of arteries. This buildup restricts the flow of blood to the stomach, arms and head – but particularly in the legs – causing pain and numbness when walking or climbing stairs. Painful cramping in calves, thighs or hips after certain physical activities like walking or climbing stairs is common. Peripheral vascular disease, which can also be called Peripheral Artery Disease, increases the risk for infection, tissue death (gangrene), heart attack, stroke and amputation.
Baptist Health is known for advanced, superior care for patients with heart conditions and the diagnosis, treatment and management of peripheral vascular disease. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.
Types of Peripheral Vascular Disease
Peripheral Vascular Disease Unspecified: Claudication can be intermittent with no specific type below indicated.
Arterial Peripheral Vascular Disease: Peripheral artery disease is a condition of the blood vessels that leads to narrowing and hardening of the arteries that supply the limbs. The narrowing of the blood vessels leads to decreased blood flow, which can injure nerves and other tissues.
Atherosclerotic Peripheral Vascular Disease: Atherosclerosis develops as plaque – fat, cholesterol and other cellular waste – builds up inside your blood vessels, causing them to grow thick and stiff. This gradual process often restricts the flow of oxygenated blood and nutrients to organs and tissues.
Advanced Peripheral Vascular Disease: Peripheral vascular disease becomes advanced with aging and can cause critical narrowing of the arteries resulting in a lack of blood and oxygen to the heart.
Bilateral Peripheral Vascular Disease: Peripheral vascular disease is detected in both sides of the heart, not just one.
Migraine Occlusive Peripheral Vascular Disease: Pain in the head and eyes is present during physical activity.
Peripheral Vascular Disease Signs and Symptoms
The most common symptom of peripheral artery disease is cramping in the lower extremities. Other peripheral vascular disease symptoms include:
- Painful cramping or numbness in the leg, hip, thigh or calf muscles after activity
- Burning or aching sensation at rest, commonly in the toes and at night while lying flat
- Weak or absent pulses in the legs or feet
- Sores or wounds on the toes, feet or legs that heal slowly, poorly, or not at all
- Shiny skin or a pale or bluish skin color
- A cold sensation or lower temperature in one leg compared to the other leg
- Poor toe nail growth or thickened, opaque toenails
- Decreased hair growth on the legs
- Erectile dysfunction, especially among men who have diabetes
Diagnosis of Peripheral Vascular Disease
If peripheral vascular disease is suspected, we perform a physical examination and ask questions about symptoms. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Common diagnostic procedures can include:
Angiogram: A thin tube (catheter) is inserted into a blood vessel and dye is injected to make the blood vessel visible during an X-ray. This can show if there are blood clots or blockages.
Ankle brachial index test: During this test, blood pressure cuffs are placed on the arms and ankles. A handheld ultrasound device or Doppler is used to listen to the blood flow and measure the blood pressure. This helps doctors understand if there is decreased blood flow to the lower legs and feet.
Blood test: Blood tests check the levels of certain fats, cholesterol, sugar and protein in the blood that could indicate heart conditions.
Computed tomographic angiography (CT): This non-invasive test can show the arteries in the abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.
Coronary angiography: This procedure often is done with cardiac catheterization. During the procedure, dye that can be seen on an X-ray is injected into the heart chambers or coronary arteries. The dye lets a physician study blood flow through the heart and blood vessels to detect any blockages.
Ultrasound: An ultrasound device can measure blood pressure on various points of your arm or leg, which will help the physician determine if you have any blockages and how quickly blood flows through your arteries.
The prognosis for people with peripheral vascular disease depends upon strict adherence to a healthy lifestyle, including diet, exercise and proper control of diabetes, high blood pressure and high cholesterol.
Peripheral Vascular Disease Causes
Preventable peripheral vascular disease causes can include:
- Obesity (a body mass index over 30)
- Physical inactivity
- High LDL (“bad”) cholesterol
- High blood pressure
Risk Factors of Peripheral Vascular Disease
Risk factors for peripheral vascular disease include:
Atherosclerosis: Known as “hardening of the arteries,” this gradual process of cholesterol plaque buildup causes inflammation in the inner walls of the arteries which may, over time, restrict or block blood flow.
Age: The risk of PVD increases after the age of 50.
Diabetes: The high blood sugar level of people with diabetes can over time make the blood vessels more likely to become narrowed or weakened, accelerating the development of atherosclerosis.
Heredity: Those with a family history of premature heart attacks or strokes are at greater risk of PVD.
Peripheral Vascular Disease Prevention
While many risk factors cannot be controlled, you can help prevent peripheral vascular disease in these ways:
Don’t smoke: Smoking contributes to constriction and damage of the arteries.
Get active: Regular exercise helps condition muscles to use oxygen more efficiently. Success in treatment is often measured by how far a person can walk without pain.
Control high blood pressure and cholesterol: If you have high blood pressure or high cholesterol, take medications as prescribed.
Maintain a healthy weight: A heart-healthy diet low in saturated fat, along with regular exercise, can control weight and promote healthy blood pressure and cholesterol levels.
Manage your diabetes: If you have diabetes, keep blood sugar levels under tight control.
Peripheral Vascular Disease Treatment
Peripheral vascular disease treatment depends on managing risk factors and treating symptoms. The main treatments for peripheral vascular disease treatment are:
Lifestyle Changes: Eat healthy, get regular exercise, maintain a healthy weight and quit smoking.
Medications: If you have high blood pressure, high cholesterol or diabetes, be certain to take your prescribed medications as directed. Your doctor may also prescribe medication to treat leg pain.
Surgery: Surgical treatments may be recommended to improve blood flow and can include:
- Angioplasty and stenting: During this procedure, a small balloon is inserted to widen narrowed or blocked blood vessels and improve blood flow. A vascular surgeon sometimes inserts a stent, a tiny metal mesh tube, to support artery walls and keep blood vessels wide open.
- Atherectomy: This procedure, similar to angioplasty, removes plaque that blocks arteries to improve blood flow. During this procedure, a thin tube (catheter) is inserted into a vein or artery via a small incision in the arm, neck or groin. The catheter is carefully threaded into the blocked artery. The tip of the catheter removes the plaque and collects it. When the catheter is removed, the plaque comes with it.
- Bypass grafting: This surgery creates a bypass around narrowed arteries to improve blood flow, by grafting arteries or veins taken from other parts of the body.
Complications of Peripheral Vascular Disease
Complications of peripheral vascular disease may include:
Amputation: Peripheral vascular disease can lead to loss of the affected limb.
Blood clots: Plaque buildup can lead to blood clots which, if dislodged, can cause a heart attack or stroke.
Claudication: This pain or cramping is caused by too little blood flow, usually during exercise, that generally affects the blood vessels in the legs.
Critical limb ischemia: When peripheral vascular disease interrupts the flow of blood to the legs, the lack of circulation can cause sores and infections to not heal properly and tissue death (gangrene), which can lead to amputation.
Restricted mobility: Pain in the affected leg can restrict mobility.
Stroke: People with PVD are three times more likely to have a stroke than those who do not have the condition.
Can Peripheral Vascular Disease Be Cured?
While there is no cure for peripheral vascular disease, this condition can be managed through lifestyle changes, medications or surgery. Baptist Health is known for advanced, superior care for patients with heart disease and the diagnosis, management and treatment of heart failure. The American Heart Association awarded us with the Get With the Guidelines® Bronze Award in 2016 for consistent application of quality measures in treating heart failure.
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