What Is Peripheral Vascular Disease?
Peripheral vascular disease or PVD is a disease of the blood vessels present outside of the heart and brain, especially the arteries of the legs, and is caused by the deposition of cholesterol and other fats. Other parts of the body that are affected are the arms, stomach, kidneys, and intestines. Peripheral artery disease (PAD) is the most common form of PVD. This causes less blood to flow through the arteries and eventually decreases oxygen supply (ischemia), and causes symptoms from this reduced blood supply. A particular person suffering from perivascular disease may experience aggravated pain while exercising or vigorous movements.
What Are the Types of Peripheral Vascular Diseases?
There are two types of peripheral vascular diseases:
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Functional Peripheral Vascular Disease - This type of peripheral vascular disease will not include any damage to the blood vessels. Rather, the blood vessels will narrow or widen in response to certain factors like brain signals and temperature changes.
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Organic Peripheral Vascular Disease - This type of peripheral vascular disease includes plaque accumulation, blood clots, and injury to the blood vessels.
What Are the Causes of Peripheral Vascular Disease?
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Accumulation of fat deposits inside the arteries and forming a plaque is the main reason for peripheral vascular disease (PVD). This condition is known as atherosclerosis.
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The presence of high blood sugar (diabetes) for a longer time will damage the blood vessels. If the same person has high blood pressure, too, atherosclerosis will result.
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Even the presence of blood clots can obstruct blood flow.
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Blood vessels can get damaged due to infections like salmonella and syphilis.
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Mental stress and extreme cold temperatures can cause functional peripheral vascular diseases.
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Conditions like deep vein thrombosis, varicose veins, thrombophlebitis, and Raynaud’s phenomenon can also cause.
What Are the Signs and Symptoms of Peripheral Vascular Disease?
Depending on the severity of the disease, symptoms can be as follows:
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Skin dryness, darkening, and peeling.
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Pain on walking or exercise. This is the most common sign of perivascular disease.
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Pain even at rest.
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Skin ulceration (wounds) over the toes or feet.
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Large non-healing ulcers over the feet or legs.
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Skin discoloration and severe skin dryness in feet and ankles a common symptoms.
Who Is at Risk of Developing Peripheral Vascular Disease?
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High blood lipids or high cholesterol present for a long time will increase the risk of peripheral vascular disease.
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Diabetes or high blood sugar level.
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If a person has a family history of stroke, diabetes, high cholesterol, and high blood pressure.
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Smoking increases the risk of peripheral vascular disease.
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Obese people are more likely to develop peripheral vascular disease.
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People of African-American origin are more likely to develop peripheral vascular disease.
What Are the Possible Complications of Peripheral Vascular Systems?
The peripheral vascular system has to be treated at the earlier stages; otherwise, it may lead to various complications, as follows.
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Affected individuals may suffer from impotence or infertility.
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The skin may become pale.
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The affected individual may experience immense pain both while resting and moving. In some cases, the patient may not be able to move, and mobility will be restricted.
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In severe cases, the bone and the blood can get affected and result in life-threatening conditions.
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The most severe complication includes the blockage of arteries that supply the heart and brain. This may cause heart attack, stroke, or even death in the worst case.
How to Diagnose Peripheral Vascular Disease?
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Feeling for the leg pulses at various anatomical locations can help determine the loss of blood supply to that leg.
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A color Doppler ultrasound/a CT (computed tomography) or magnetic resonance angiogram can also be done to document blocks in the arteries of the feet. Angiography is done to find if there is any blockage in the vessel. It is done by injecting a dye into the artery through a catheter. MRI (magnetic resonance imaging) will be performed to detect blockages in the artery. Doppler ultrasound will help detect the blood flow.
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Patients will be advised to undergo blood tests to detect conditions that may increase the severity of peripheral vascular disease, like diabetes, hypertension, and high cholesterol.
How Can Peripheral Vascular Disease Be Managed Effectively?
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 pinhole 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.
Medications that the patient will be prescribed are as follows:
a) Aspirin and Clopidogrel - To prevent blood clotting.
b) Statins to reduce cholesterol levels.
c) Medications to reduce blood sugar levels.
Can This Disease Recur After Angioplasty?
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Yes, unless the risk factors are eliminated, the disease can come back.
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One still needs to stay off of all kinds of tobacco, have good blood pressure and diabetes control, and continue to take blood thinning medications.
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Patients who go back to smoking after their symptoms reduce; invariably have a recurrence that needs to be treated.
How Long Do One Need to Stay In the Hospital For An Angioplasty?
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 pinhole over the groin, there is very little downtime. One can walk around six hours after the procedure and go home the next day.
What Is the Outlook of PVD?
If this condition is diagnosed at the early stages then lifestyle changes can help. The only way to know about improvement is by measuring how far the person can walk without pain. With proper treatment, the person should be able to walk longer distances without pain. Immediate consultation with the doctor must be done when
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Legs start to look pale or blue.
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Legs tend to become cold.
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Causes of chest pain along with leg pain.
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Development of new sores or ulcers.
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Fever, chill, and weakness.
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Signs of other infection.
Conclusion
Peripheral vascular disease (PVD) is a condition that can cause some serious life-threatening conditions. Lifestyle modifications, appropriate treatment with medication to control the underlying medical conditions, and surgery to repair the damages can help the affected individual cope.