What is Peripheral Vascular Disease?

Peripheral vascular disease (PVD) is a condition that occurs when the arteries that carry blood to your arms or legs become narrowed or clogged. The result is a slowing or stoppage of the blood flow through these arteries.

PVD is caused by atherosclerosis (hardening or the arteries), which gradually causes a build-up of cholesterol and scar tissue inside the artery. This build-up forms a substance called "plaque" that clogs the artery.

Risk Factors and Symptoms

PVD affects about 1 in 20 people over the age of 50, or about 8 million people in the United States. If you are over the age of 50, or have hypertension, diabetes, or high cholesterol, you run a greater risk of developing PVD. Smokers and those who are overweight or don't exercise regularly are also at risk.
If you have any of these risk factors, learn to recognize the symptoms and warning signs of PVD:

• Cramping, leg or hip pain which occurs when you walk, but goes away when you rest
  
• Numbness, tingling or weakness in the legs
  
• Burning or aching pain in your feet or toes when resting
  
• A sore on a leg or foot that won’t heal
  
• Cold legs or feet
  
• Loss of hair on your legs
  

If you are over 50 and have been dismissing numbness and leg pain as "normal signs of aging," you might consider having a physician test you for PVD.

Diagnosing PVD

The most common test for PVD is the ankle-brachial index (ABI) and arterial Doppler, a painless exam which compares the blood flow between your feet and arms. Based on the results of your ABI, as well as your symptoms and risk factors for PVD, a doctor can decide if further tests are needed. If the ABI test indicates that you may have PVD, other imaging modalities—such as an angiogram—are typically ordered to confirm the diagnosis. On occasion, MRI scanning or CT scanning might be ordered.

Treatment Options

The treatment your doctor recommends will depend on your overall health as well as the severity of the disease. Here are a few options:

Lifestyle Changes

In most cases, lifestyle changes can be enough to slow the progression of, or reverse, the disease. Your doctor may suggest that you quit smoking, begin an exercise regimen, and change your diet to one that is lower in fat and cholesterol.

Medication

Some people will need to take a cholesterol-lowering medication, or medication that controls high blood pressure. These may be prescribed in addition to lifestyle changes.

Procedures to Open Blocked Blood Vessels

There are a number of procedures that doctors use to open blood vessels at the site of blockages caused by PVD. In many cases, these procedures can be performed without surgery using modern, interventional radiology techniques.

Surgical Procedures

Most of the time, lifestyle changes, medication and/or an interventional procedure can alleviate PVD. Sometimes, however, surgical intervention is needed. Surgery for PVD is performed by cardiothoracic or cardiovascular surgeons.