What are the symptoms of Peripheral Vascular Disease?

As the internal lining of the artery thickens from the atherosclerotic plaque, the blood vessel becomes increasingly constricted and blood flow diminishes. Therefore, the symptoms you may experience depend on what artery is affected and how severely the blood flow is reduced.a

Some of the symptoms you may experience in the affected areas are:

• Claudication (dull, cramping pain in hips, thighs or calf muscle) 
• Infection/sores that do not heal 
• Ulceration or gangrene

Clinical studies have identified factors that increase the risk of PVD. Some of these factors cannot be changed, while others can be managed to greatly reduce your risk of the disease. They are as follows:

• Diabetes: PVD is common among those individuals with diabetes. This correlation is due to complications of the disease, which may cause damage to the large and small blood vessels of the legs and feet.
• Smoking: The risk of PVD dramatically increases in smokers. When a person stops smoking, regardless of how much he or she may have smoked in the past, their risk of PVD rapidly declines.

Any of the following risk factors may also increase your chance of developing PVD:

• Obesity (being overweight)
• High blood pressure
• A family history of the disease
• Lack of exercise
• Coronary artery disease
• Age greater than 65
• Hyperlipidemia (high cholesterol)

How is PVD diagnosed?

If your doctor suspects that you have PVD, or if you have symptoms of the disease, several tests are performed to diagnosis it. Such diagnostic tests include:

• Ankle Brachial Index (ABI)
• Doppler Ultrasound Test
• CAT Scan or MRI
• Angiogram

What are the treatments of PVD?

Many treatments can be used to improve blood flow through the peripheral arteries. The latest interventions for treating PVD can bring relief and are more cost effective than surgery. Most procedures require no more than an overnight hospital stay, and patients enjoy an early return to most normal activities. Techniques available to you include:

• Antioplasty and stents - a non-surgical treatment designed to open clogged arteries. This procedure is done after the doctor has seen the angiogram that shows where the arteries are blocked. Angioplasty, with or without stenting, opens the arteries to restore blood flow. Stenting involves implanting a metal tube (Stent) into an artery during an angioplasty. The stent provides scaffolding to hold the vessel open to improve the flow of blood to the heart.
  
  
• Atherectomy - a minimally invasive intervention procedure that involves the excision and removal of blockages by catheters with miniature cutting systems.
  All of atherectomy techniques treat the build-up of plaque by either removing it, compressing it or displacing it. During these procedures, the physician will periodically inject a contrast dye and take x-ray pictures to determine whether or not the artery is sufficiently open. If the blockage is extremely long or has become very hard and calcified with time, it may be resistant to any of these procedures. In these cases, surgery may be required to bypass the problem area.
  
  
• Turbo Laser - small fiberoptic catheter transmits bursts of “cool” ultraviolet energy through the flexible fibers of the catheter. The ultraviolet energy penetrates the lesion vaporizing the blockage. Once the blockage is cleared, the catheter is withdrawn from the small puncture site in the leg.

Other important measures that may be used to treat PVD include:

• Exercise - exercise may improve arterial blood flow to the affected limb. Exercise is not recommended for people with severe pain at rest, venous ulcers or gangrene. Consult your doctor before beginning an exercise program.
  
  
• Stop Smoking - Smoking causes vasoconstriction (decreases the diameter of blood vessels), which can interfere with adequate blood flow to the limbs. Emotional stress, exposure to cold temperatures and caffeine can all cause vasoconstriction.
  
  
• Medications – Medications that are occasionally prescribed to patients with PVD include antiplatlet medications (such as Aspirin and Plavix), those that increase blood flow (Cilostazol (Pletal)) or cause vasodilation (calcium channel blockers such as Amlodipine or Verapamil).
  

  
  Vascular screenings are available to help diagnosis vascular disease. For more information about these screenings or to receive a referral to a vascular specialist, call 513-585-1000.

The following physicians treat peripheral vascular disease: