Peripheral Vascular Disease

Peripheral Vascular Disease

What is peripheral vascular disease (PVD)?

Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels—the arteries, veins, or lymphatic vessels. Organs supplied by these vessels such as the brain, heart, and legs, may not receive adequate blood flow for ordinary function. However, the legs and feet are most commonly affected, thus the name peripheral vascular disease.

Illustration of circulation system of the legs
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Conditions associated with PVD that affect the veins include deep vein thrombosis (DVT), varicose veins, and chronic venous insufficiency. Lymphedema is an example of PVD that affects the lymphatic vessels.

When PVD occurs in the arteries outside the heart, it may be referred to as peripheral arterial disease (PAD). However, the terms "peripheral vascular disease" and "peripheral arterial disease" are often used interchangeably. It's frequently found in people with coronary artery disease, because atherosclerosis, which causes coronary artery disease, is a widespread disease of the arteries.

Illustration of the circulatory system, arterial and venous
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Conditions associated with PAD may be occlusive (occurs because the artery becomes blocked in some manner) or functional (the artery either constricts due to a spasm or expands). Examples of occlusive PAD include peripheral arterial occlusion and Buerger's disease (thromboangiitis obliterans). Examples of functional PAD include Raynaud's disease, Raynaud's phenomenon and acrocyanosis.

What causes peripheral vascular disease?

PVD is often characterized by a narrowing of the vessels that carry blood to the leg and arm muscles. The most common cause is atherosclerosis (the buildup of plaque inside the artery wall). Plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue. Clots may form on the artery walls, further decreasing the inner size of the vessel and potentially blocking off major arteries.

Illustration of a normal and diseased artery
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Other causes of peripheral vascular disease may include trauma to the arms or legs, irregular anatomy of muscles or ligaments, or infection. People with coronary artery (arteries that supply blood to the heart muscle) disease are frequently found to also have peripheral vascular disease.

What conditions are associated with peripheral vascular disease?

The term "peripheral vascular disease" encompasses several different conditions. Some of these conditions include, but are not limited to:

What are the risk factors for peripheral vascular disease?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, diet, family history, or many other things. Risk factors for peripheral vascular disease include factors which can be changed or treated and factors that cannot be changed.

Risk factors that cannot be changed include:

Risk factors that may be changed or treated include:

Those who smoke or have diabetes mellitus have the highest risk of complications from peripheral vascular disease because these risk factors also cause impaired blood flow.

What are the symptoms of peripheral vascular disease?

Approximately half the people diagnosed with peripheral vascular disease are symptom free. For those experiencing symptoms, the most common first symptom is intermittent claudication in the calf (leg discomfort described as painful cramping that occurs with exercise and is relieved by rest). During rest, the muscles need less blood flow, so the pain disappears. It may occur in one or both legs depending on the location of the clogged or narrowed artery.

Other symptoms of peripheral vascular disease may include:

The symptoms of peripheral vascular disease may resemble other conditions. Consult your physician for a diagnosis.

How is peripheral vascular disease diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for peripheral vascular disease may include any, or a combination, of the following:

What is the treatment for peripheral vascular disease?

There are two main goals for treatment of peripheral artery/vascular disease: control the symptoms and halt the progression of the disease to lower the risk of heart attack, stroke, and other complications.

Specific treatment will be determined by your physician based on:

Treatment may include:

With both angioplasty and vascular surgery, an angiogram is often performed prior to the procedure.

What are the complications of peripheral vascular disease?

Complications of peripheral vascular disease most often occur because of decreased or absent blood flow. Such complications may include:

By following an aggressive treatment plan for peripheral vascular disease, complications such as these may be prevented.

Can peripheral vascular disease be prevented?

Steps to prevent PVD are primarily aimed at management of the risk factors for PVD. A prevention program for PVD may include:

A prevention plan for PVD may also be used to prevent or lessen the progress of PVD once it has been diagnosed. Consult your physician for diagnosis and treatment.

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