Peripheral vascular disease (PVD), or peripheral arterial disease (PAD), is a condition in which the arteries that carry blood away from the heart become narrowed or clogged, which results in slowing or stopping the flow of blood.
The most common location for PVD is in the legs, but it can occur in other places such as the neck or arteries of the kidney.
According to Dr. Christopher Marrocco, a vascular surgeon at Scott & White Healthcare – Temple, PVD can be categorized into two types: atherosclerotic and non-atherosclerotic.
Atherosclerotic PVD results from hardening of the arteries, and is caused by the same type of plaque that can build up in the heart to cause a heart attack or in the neck arteries to cause a stroke.
Non-atherosclerotic PVD can have many causes; some are reversible and may be related to abnormal vessel constriction or spasm, while others are non-reversible and result in structural changes in the blood vessels (such as inflammation and tissue damage).
“Most patients with PVD should be reassured that, with respect to their legs, the condition typically runs a benign course,” Marrocco said. “Less than one third of patients will require any surgical or radiologic intervention.”
It’s important to know the symptoms of PVD. The most common symptom is pain in the leg, particularly when walking. Other symptoms may include numbness, tingling and weakness in the leg.
In severe cases, patients may develop an ulcer or sore on the leg or foot that doesn’t heal. If left untreated, ulcers can become infected. In extreme cases, untreated PVD can lead to gangrene, a serious condition that may require the amputation of a leg or foot.
While it is not known why PVD occurs in some people, many people with PVD have smoked at one time or another in their life. Those who are overweight or who have high blood pressure, high cholesterol, diabetes or a family history of heart or vascular disease are also at an increased risk for developing peripheral heart disease.
Effective reduction of the risk of cardiovascular disease depends on coordinated and stringent modification of identifiable risk factors to prevent progression or new disease and the use of drugs to correct existing abnormalities. Exercise programs and dieting to lose weight and lower blood cholesterol are indispensable for controlling PVD, and many will require additional medication.
The single most important thing you can do to slow PVD is stop smoking.
“When lifestyle changes and medication are not enough to control the symptoms of PVD, there are a number of ways that physicians can open blood vessels at the site of blockages and restore normal blood flow,” Marrocco said. “In many cases, these procedures can be performed without open surgery using modern, interventional cardiovascular techniques.”
Some of these options include:
- Angioplasty: In this procedure, a tiny balloon is placed in the blood vessel at the site of the blockage. It is then inflated to open the artery.
- Stents: This treatment involves a tiny wire mesh metal cylinder, or stent, which is inserted in the clogged vessel to act like scaffolding and hold it open. Stents and angioplasty are often used together.
- Thrombolytic therapy: This treatment involves thrombolytic or clot-busting drugs, which are delivered to the site of blockages caused by blood clots. The drugs dissolve the clot and restore blood flow.
- Stent grafts: In this procedure, a stent covered with synthetic fabric is inserted into the blood vessels to bypass diseased arteries.
- Bypass surgery: Using a vein or a plastic tube to bypass, or go around, blockages in the arteries to restore blood flow to the tissues past the blockage or obstruction.
The best treatment for PVD is different for each individual. Your treatment should depend on a number of factors, including your overall health, the location of the affected artery and the size and nature of the blockage or narrowing in the artery. You should discuss all treatment options with your physician in order to determine which procedure is best for you.
For additional information about Scott & White Healthcare, please visit www.sw.org.
