Peripheral vascular disease occurs when blood vessels become narrowed, restricting the flow of blood to a body part. This can lead to pain, numbness and a cold or dark color in the affected area. In severe cases, the blood flow can stop and gangrene can form. This is a life-threatening condition that requires treatment.
Symptoms
Peripheral vascular disease (PVD) occurs when blood vessels narrow or become blocked, restricting blood flow to the arms, legs and other body parts. It usually develops in the arteries that carry oxygen-rich blood to the limbs and other body areas. PVD is most common in people over 60. It affects about 8 million people in the United States.
The main cause of PVD is atherosclerosis, which is the buildup of fatty, cholesterol-containing deposits (plaques) on artery walls. The plaque narrows arteries, which reduces the amount of oxygen and nutrients sent to tissues. People with diabetes and who smoke are at increased risk of developing PVD.
Symptoms of PVD vary depending on the type of PVD and the affected blood vessels. People with PVD in the arteries of the feet and legs often have pain or cramping that starts during activity and goes away with rest. The most common symptom is called claudication, which means that the muscles in the legs do not get enough oxygen to work properly.
Other symptoms of PVD in the arteries of the legs include sores that do not heal and changes in skin color. The arteries in the kidneys can also narrow or block, restricting blood flow to the kidneys. A person with PVD in the carotid arteries may have no symptoms or only minor ones, such as a headache or dizziness, before having a stroke or transient ischemic attack (TIA or mini-stroke).
Many people with PVD do not have any symptoms. Others have mild or moderate symptoms, such as pain or cramping that starts in the legs when walking or exercising and goes away with rest. Some people have severe symptoms, including amputation of the foot or leg.
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To diagnose PVD, your doctor will ask about your past health and family history, and do a physical exam. Your doctor will look for signs of damaged blood vessels, such as swelling and numbness. Your doctor may order blood tests or imaging tests, such as ultrasound and angiography. Your doctor may also recommend treatments, such as diet and exercise, medicine or surgery.
Diagnosis
Peripheral Vascular Disease (PAD) is a narrowing of the blood vessels that carry oxygen-rich blood from your heart to your arms, legs, and feet. It is most often caused by atherosclerosis, a condition in which fatty material builds up inside the walls of your arteries. The buildup slows or stops blood flow through the artery and can lead to a blood clot.
In PAD, the clogged or narrowed areas of your arteries are called lesions. These lesions usually cause pain or discomfort with walking (claudication). The pain may go away during rest, but if the condition is severe, it can prevent you from being able to walk or do other physical activities. You also may notice that your legs are numb, or they feel cold when you sit or lie down. You may have other symptoms, such as leg cramps or sores that don’t heal well.
People with PAD have different symptoms, depending on where their arteries are blocked or narrowed. For example, lower-extremity PAD affects the arteries that supply blood to your feet and legs. It is the most common form of the disease, and it occurs in about 8.5 million people in the United States.
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You are more likely to have PAD if you smoke or have diabetes. Both conditions make it harder for your blood to circulate, and they can speed up the buildup of fatty materials in your arteries.
A health care provider can diagnose PAD by doing a physical exam and asking about your past medical history. They may also order noninvasive tests to find the clogged or narrowed arteries. These include an ankle-brachial index test, which compares your blood pressure in the ankle to your arm. Your doctor may also order an ultrasound test to check the size of your arteries and look for any blockages.
Effective treatment for PVD aims to stop or slow the progression of the disease and reduce your risk of serious complications. Your treatment plan may include lifestyle changes, medication, or surgery. Some treatments involve cutting out or removing the affected artery and then using a stent to keep it open.
Treatment
In healthy people, blood flows freely through veins and arteries. But in people with peripheral vascular disease, or PVD, atherosclerosis causes fatty deposits to narrow the insides of blood vessels in the legs and arms. This restricts the flow of oxygen and nutrients to these body parts. If not treated, PVD can cause serious problems. These include blood clots, which can block off the artery completely, cutting off the supply of oxygen and nutrients to the tissue. This can lead to painful and swollen feet, cold or dark skin, and wounds that won’t heal. People with PVD are also at increased risk of developing coronary artery disease and stroke.
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A doctor can diagnose PVD with a physical exam, including checking the pulse and blood flow in the arms and legs. He or she may order noninvasive tests, such as ultrasound of the legs or feet and Doppler ultrasonography, to see how blood moves through the vessels and find any blockages. In some cases, doctors need to use invasive tests to find the location of a blocked artery. This is done with a procedure called an angiogram, which involves injecting dye into the artery and using special imaging tests to find any blockages.
Treatment options for PVD include lifestyle, medical and surgical treatments. Lifestyle therapies include walking exercise programs, smoking cessation and dietary modification. Medical treatments include medicines to improve blood flow and treat other conditions that worsen PVD, such as diabetes, high blood pressure and high cholesterol. These medicines can reduce the buildup of plaque and decrease your risk of having blood clots or heart attack. Surgical treatments for PVD include angioplasty and stenting to open up the clogged artery, and bypass surgery, which uses a blood vessel from another part of the body or a tube made of synthetic material to reroute the blood flow around a blocked artery.
The best way to prevent PVD is to follow your health care provider’s advice about managing your risk factors. You can’t control all of them, but you can try to lower your risks by exercising regularly and eating a balanced diet. If you have early symptoms, such as pain or swelling in your feet or legs, make an appointment with your health care provider.
Prevention
The main cause of PVD is atherosclerosis, or hardening of the arteries. This means fatty deposits build up inside a blood vessel, usually an artery, narrowing it and reducing the flow of oxygen to that body part. The condition most commonly affects blood vessels in the legs and feet, although it can occur in other parts of the body, including the arms and heart. If atherosclerosis occurs in the arteries of the heart, it is called coronary artery disease. If atherosclerosis occurs in the brain, it is called cerebrovascular disease.
The symptoms of PVD are often mistaken for signs of other medical problems, especially arthritis and muscle injuries. Many people with the disease have no symptoms at all. It is important to have any symptoms evaluated because early diagnosis and treatment of PVD can help prevent more serious complications, such as amputation or loss of limbs.
Risk factors for peripheral vascular disease include age, diabetes, smoking, and high cholesterol levels. These factors increase your risk for developing atherosclerosis, which causes the arteries to narrow or become blocked. Atherosclerosis also increases your risk for cardiovascular disease, such as heart attack and stroke.
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To diagnose PVD, your health care provider will perform a physical exam and review your past health history and symptoms. Your doctor may order noninvasive tests, such as an ultrasound test that uses sound waves to create pictures of how blood moves through your legs or feet, and an angiography test, which uses imaging tests with dye to find blockages in your arteries.
Symptoms of PVD can be treated with lifestyle changes, medicines, and procedures, such as angioplasty and stenting. Quitting smoking and controlling your blood sugar, cholesterol, blood pressure, and weight can improve symptoms and slow the progression of the disease. It is important to get regular exercise, such as walking, and to eat healthy foods that are low in fats and sugars. If you have severe symptoms, such as painful calf or foot ulcers that do not heal, your doctor might recommend surgery to treat the disease and stop further damage.
