Peripheral Vascular Disease (PVD)/Peripheral Artery Disease (PAD)
Peripheral vascular disease (PVD) is a common progressive circulation disorder that affects the blood flow through blood vessels (veins or arteries) in your body. PVD is caused by an obstruction in the arteries making them too blocked or weakened to carry blood to the arms, legs, stomach or kidneys. PVD can result from atherosclerosis, which is an inflammatory condition, leading to the narrowing of blood vessels. This causes a lack of blood supply, most often in the legs and feet. When the condition occurs in the arteries, it is called peripheral artery disease (PAD), but often PVD and PAD are used interchangeably.
People with PVD have a dramatically increased risk for heart attack. The disease can impair overall physical health. When arteries to the legs are affected, the ability to walk can also be impaired.
Symptoms of PVD/PAD
PVD is often identified by the following symptoms:
- Pain or cramping in legs, thighs, calves or feet when you walk or exercise that subsides with rest
- A weak or absent pulse in the legs or feet
- Sores or wounds on the toes, feet or legs that heal slowly, poorly or not at all
- Color changes in skin, such as paleness or blueness, called cyanosis
- Decreased temperature in one leg compared to the other
- Poor nail growth and decreased hair growth on toes and legs
Diagnosing and Treating PVD/PAD
Your doctor will begin with a full exam, medical history and may order the following diagnostic tests.
- An ankle brachial index (ABI) is a non-invasive test that compares the blood pressure reading in the arm and ankle.
- An angiograph involves injecting a special contrasting dye (under a local anesthetic) into the arteries and taking X-rays to reveal any narrowing or blockages.
- A doppler ultrasound examines the affected limb. It is a non-invasive test using sound waves to provide an image of the inside of the blood vessel to help determine if an artery has plaque buildup.
- Cardiac magnetic resonance angiogram, computed tomography (CT) or a coronary angiogram are diagnostic imaging tests that also help identify blocked arteries.
If PVD/PAD is diagnosed, medication may be prescribed to lessen the symptoms. When symptoms can no longer be sufficiently controlled with medication, there are interventional options.
- Percutaneous transluminal angioplasty is the catheter-based removal of plaque.
- Endarterectomy is an open-surgical procedure to remove plaque.
- Bypass graft surgery redirects blood flow around a blocked blood vessel by creating a new pathway for blood flow using a graft.