Peripheral Vascular Disease
Peripheral vascular disease, also called peripheral arterial disease, is a condition in which plaque builds up in blood vessels supplying the legs. When plaque builds up in the heart, it can cause chest pain or a heart attack and when it builds up in the arteries going to the brain, it causes a stroke. Similarly, plaque in the arteries of the leg restrict blood flow and cause pain or, in more severe cases, open sores or gangrene. This type of plaque build up is more common in diabetics, smokers, people with high cholesterol, kidney failure and people over age 50.
Signs and Symptoms
The most common symptom is pain with walking, known as claudication. This can happen in the feet, calves, or thighs and usually improves with rest. A more severe form of claudication, called “rest pain,” is a constant pain that worsens at night and improves with standing up or hanging the legs off the side of the bed. It can disrupt sleep at night and is sometimes associated with redness of the feet when standing or sitting.
Your doctor will take a history and examine your legs and feet to check for pulses. The most common tests include:
- Ankle-brachial index/pulse volume recordings (ABI/PVR) compares blood pressure of your ankle to blood pressure in the arm and checks the strength of the pulses
- Doppler ultrasound checks the flow of blood through your leg
- CT or MRI can determine the location of plaque in your blood vessels
- Arteriogram produces an image of your arteries using contrast dye and X-ray. Through these images, your doctor can observe the flow of blood through your arteries and note any blockage
- Blood tests are done to diagnose diabetes and high cholesterol
In mild cases lifestyle changes and medication can help. For example, smokers must stop smoking or face a substantial risk of making the disease much worse. Regular exercise can help build up muscles that can work even with a reduced supply of blood. Additionally, improving cholesterol and blood pressure numbers can slow the progression of disease. Diabetics should make sure that they have good blood sugar control, and may want to consider working with our Diabetes Education team to learn more about how to stay healthy.
Many patient receive minimally invasive procedures called angiograms to improve blood flow to the legs. Other minimally invasive procedures include atherectomy, and angioplasty. Depending on your other medical conditions and the complexity of your disease your surgeon may choose to do the procedure in our outpatient angiography suite or recommend an overnight stay in the hospital.