Peripheral vascular disease (PVD)

Overview

Peripheral vascular disease (PVD), also referred to as peripheral artery disease (PAD), is a common but serious condition in which narrowed arteries and veins outside of the heart – such as those in the arms, legs, neck or near the kidneys or intestines – reduce blood flow to the limbs, most often the legs.

When arteries become blocked or narrowed, blood can't flow properly and the muscles of your legs don't receive enough oxygen. PVD also may be a sign of atherosclerosis, a more widespread build-up of plaque in the arteries. In patients with atherosclerosis, this underlying condition may be reducing blood flow to the heart and brain as well as the legs. Left untreated, PVD can lead to heart attack, stroke, high blood pressure, kidney failure, heart disease, heart failure or even amputation.

Specially trained cardiologists who focus on the managing the peripheral vascular system see patients with vascular disease. These specialists work in collaboration with a team of clinicians from multiple disciplines, including:

  • Primary care
  • Diabetes and podiatric medicine
  • Vascular medicine and intervention
  • Vascular surgery
  • Vascular imaging and intervention
  • Nutrition and physical therapy
  • Wound care

Peripheral Vascular Disease

Video discussing peripheral vascular disease and treatement options.

Symptoms

While many people with PVD have mild or no symptoms, but the following symptoms should be brought to your doctor’s attention:

  • Leg pain, leg cramping or fatigue in the hip, thigh or calf muscles after activity such as walking or climbing stairs, which often stops when you stop walking — this is called claudication or intermittent claudication
  • Pain in the arches of your feet or in your toes when you are lying down — the severity of the foot, toe or leg pain varies from mild discomfort to debilitating pain and may be intense enough to disrupt sleep
  • Skin wounds or ulcers on the toes, feet or legs that are slow to heal
  • Leg numbness or weakness
  • Coldness in lower leg or foot, especially when compared with the other leg
  • No pulse or a weak pulse in the legs or feet

Many people don’t know they have PVD, because the symptoms can be silent or confused with other disorders such as arthritis.

Risk factors

  • Men are somewhat more likely than women to have PVD.
  • One in 20 people over the age of 50 has PVD.
  • African-Americans are more than twice as likely as Caucasians to have PVD, according to the U.S. Department of Health and Human Services.
  • Your chances of developing PAD increase as you age. Approximately 12 to 20 percent of patients diagnosed with PAD are 65 years or older.

Diagnosis

We offer a full range of the most advanced diagnostic technologies, including ultrasounds, pulse volume recording, computed tomography (CT) scans and magnetic resonance imaging (MRI). In many cases, you receive same-day results following your tests. Using the most innovative diagnostic technologies, vascular specialists diagnose PVD in arteries such as:

  • Brachiocephalic (leading from the heart to the head)
  • Iliac and femoral (supplies the arms and legs)
  • Mesenteric (supplies the intestines with blood)
  • Renal (supplies the kidneys)

Treatment

The primary goal of treating PVD is to reopen the artery to allow blood to flow. Surgery is one effective treatment approach; however, our vascular specialists take a minimally invasive approach first. Our specialists will work with you to design an individualized treatment approach that is right for you. Treatments may include:

  • Angioplasty – a minimally invasive procedure in which a surgeon threads a balloon-tipped tube through arteries until it reaches the one that is blocked. The surgeon inflates the balloon, which compresses the plaque in the artery and widens the vessel.
  • Stenting  also minimally invasive and may be done at the same time as angioplasty. A stent is a small, metal mesh tube that a surgeon inserts through a catheter to prop open an artery.
  • Atherectomy  also minimally invasive, a procedure in which a device is inserted through a catheter into your arteries or veins. The device has a laser or cutting tip that cuts through the accumulated plaque and scrapes it from the artery or vein.
  • Bypass surgery  creates a new pathway for blood to flow by bypassing a blocked area in your vein or artery.
  • Hybrid open/endovascular procedures  combines traditional (open) surgery with advanced imaging technology.

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