Peripheral Vascular Disease (PVD)

Peripheral vascular disease (PVD), also known as peripheral artery disease (PAD) or peripheral artery occlusive disease (PAOD), is a collective term for all conditions caused by the obstruction of large peripheral arteries, which can result from atherosclerosis, an inflammatory processes leading to the narrowing of a blood vessel or tubular organ (stenosis), a blockage (embolism) or blood clot (thrombus) formation. PVD can cause severe or chronic ischemia (lack of blood supply), typically of the legs.

PVD is divided into four stages:

• Stage I: Claudation - patient experiences mild pain upon walking
• Stage II: Intermittent Claudation - patient feels severe pain upon walking relatively short distances
• Stage III: patient feels pain even while resting
• Stage IV: patient experiences tissue decay, also known as gangrene

Symptoms include:

• Pain, weakness, or cramping in the muscles due to poor circulation
• Poor circulation can lead to sores, wounds, or ulcers that heal slowly or not at all
• Obvious change in color (blue or pale) or temperature (cool to the touch) of the affected limb
• Lessened hair and nail growth on the affected limb and digits

Known causes include:

• Tobacco use (smokers are 10 times more likely to develop PVD)
• Diabetes Mellitus
• High overall cholesterol
• Hypertension

If you suspect you might have PVD, schedule an appointment right away to express your concerns. If your doctor agrees with your suspicion, he/she should perform an ankle brachial pressure index (ABPI or ABI). An ABPI measures the fall in blood pressure to the arteries supplying blood to the legs.

If your ABI results come back abnormal, the next step would be imaging of the affected limb, such as a lower limb Doppler ultrasound, angiography or angioplasty. As an alternative to angioplasty, CT scanners provide direct imaging of the arterial system. In severe cases of PVD, arterial bypass surgery may be required.