PVD (peripheral vascular disease) is a condition that commonly affects the arteries in the legs of older adults, smokers, and hypertensive patients. Read about its symptoms, risk factors, diagnosis, and treatment options.
Peripheral Vascular Disease or PVD is a disease of the arteries of the legs caused by deposition of cholesterol and other fats. Peripheral artery disease (PAD) is the most common form of PVD.This causes less blood to flow through the arteries and causes symptoms from this reduced blood supply.
Depending on the severity, symptoms can be
Mild disease can be treated by lifestyle modification and medications. Severe disease can be treated by Angioplasty and Stenting. This is done in a Cath Lab (catheterization laboratory) and is done via a small pin hole access in the groin. Small instruments like catheters and wires are used to reach the blocked artery and blocks are opened by inflating appropriately sized balloons across the blocks. Stents can also be placed to scaffold the treated segments and help the artery to remain open. Long segment occlusions can need surgical bypass graft placement.
Typically the patient gets admitted the day before the procedure, certain tests are done to determine the Kidney and Cardiac function. The procedure is done the next morning. Since the angioplasty is done via a small pin hole over the groin, there is very little down time. You can walk around 6 hours after the procedure and go home the next day.
The signs of vascular disease are:
- Pale or bluish skin.
- Lack of hair in the leg or toenail growth.
- Sores on feet, toes, or legs that heal slowly or do not heal.
- Decreased skin temperature, with thin, brittle, shiny skin on the feet and legs.
- Weak pulse in the legs and feet.
Peripheral vascular disease (PVD), if untreated, can lead to critical limb ischemia, a severe stage of PVD that can end up in the loss of the affected limb. But when it is diagnosed in the early stage, it is treatable and reversible. PVD can be reversed by following certain lifestyle changes like proper nutrition, regular exercise, and quitting smoking.
The following methods can help to diagnose peripheral vascular disease:
- Magnetic resonance angiography (MRA).
- Ankle-brachial index (ABI).
- Treadmill exercise test.
- Doppler ultrasound flow studies.
- Pulse volume recording (PVR) waveform analysis.
- Photoplethysmography (PPG).
- Reactive hyperemia test.
Vascular pain can occur as the result of interruption of the blood flow to the muscles or tissues. Vascular pain can be felt as pain or heaviness in certain areas where there is a lack of circulation. There can also be weakness, numbness, or a tingling sensation in the affected area.
The arteries usually bring blood to the heart and brain. In case of peripheral vascular disease, when this blood gets clogged, it will lead to stroke, heart attack, or death.
The main goal of the treatment of peripheral vascular disease is to control the symptoms and prevent further progression of the disease. Peripheral vascular disease can be treated by alteration in the lifestyle like proper nutrition, regular exercise, and quitting smoking, medication, surgery, and the combination of the treatment methods.
The stages of peripheral artery disease are:
- Stage 1 – Mild claudication.
- Stage 2 – Moderate claudication.
- Stage 3 – Severe claudication.
- Stage 4 – Rest pain.
The best drugs for peripheral vascular disease are:
- Antiplatelet agents like Aspirin or Clopidogrel.
- Cholesterol-lowering medications like statins like Atorvastatin and Simvastatin.
- Cilostazol increases the blood flow to the arteries and relieves symptoms of claudication.
- Pentoxifylline also improves the blood flow to the arteries and relieves symptoms of claudication.
- Angiotensin-converting enzyme (ACE) inhibitors to reduce high blood pressure.
The most common type of the peripheral vascular disease are:
- Myocardial infarction (MI).
- Peripheral arterial disease (PAD).
- Coronary artery disease (CAD).
The long term complication of peripheral vascular disease may include:
- Weakness in the lower-extremity with impaired functional status.
- Increased rate of functional decline.
- Infections in the extremities.
- Chronic skin ulceration.
- Sores that do not heal.
The severe form of peripheral vascular disease (PVD) is a condition where there is a narrowing of the blood vessels outside the heart that cannot deliver enough oxygen and nutrients to the body. If left untreated, PVD can cause chronic wounds on the limbs and increase heart attack or stroke risk.
Peripheral vascular disease (PVD) is a circulation disorder. There is no cure for PVD, but we can control symptoms and prevent the disease's progression by medications, alteration in the lifestyle, angioplasty, surgery, or treatment methods. The treatments can also help to reduce the risk of cardiovascular diseases like coronary artery disease and stroke. If not treated, it can lead to complications like pain, gangrene, infection of the extremities, ulcers, sores that do not heal, amputation, and death.
Last reviewed at:
03 Jan 2020 - 2 min read
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