Peripheral Vascular Disease

Peripheral Vascular Disease (PVD), also known as Peripheral Artery Disease (PAD) when it specifically affects the arteries, is a circulatory condition where narrowed blood vessels reduce blood flow to the limbs. PVD primarily affects the legs and feet and is often caused by atherosclerosis, the buildup of fatty deposits in the artery walls. This leads to restricted blood flow and can cause pain, cramping, and even ulcers in severe cases.

Peripheral vascular disease is a gradually progressive disorder in which blood vessels become narrowed or blocked, thus blood flow to organs outside the heart and brain will be reduced. Peripheral vascular disease can affect any of the arteries, veins, and lymphatic vessels but, in most cases, involve the legs and feet.
PVD is also referred to a PAD or peripheral arterial disease. The arteriosclerosis or plaque buildup can cause spasms in blood vessels. Six times an increased chance of heart attack and stroke.

Causes

The primary cause of PVD is a condition identified as atherosclerosis. Atherosclerosis is the deposition of fatty substances, plaque, in the blood vessels.

However, some of the other risk factors include:

Smoking: This is the leading cause of PVD since it causes the aggregation of plaques and low flow of the blood.
Diabetes: High sugar levels in the blood will eventually damage the blood vessels.
High blood pressure (Hypertension): It causes damage to the interior lining of the blood vessels, which encourages plaque development.
High cholesterol: Increased chance of plaques building up.
Age: The possibility of PVD increases with age, especially among those who are more than 50 years old.
Family history: Those having a positive family history concerning cardiovascular diseases are at risk.
Obesity and physical inactivity: These are conditions that tend to encourage the development of PVD

Symptoms

Symptoms of PVD can vary based on the severity of the condition, but common signs include:

Claudication: Pain or cramping in the legs, especially during physical activity (like walking), which improves with rest.
Leg numbness or weakness: Due to reduced blood flow.
Coldness in the lower legs or feet: Especially in one leg.
Color changes: Affected legs may appear paler or bluish.
Hair loss: On the legs or feet.
Slow or non-healing wounds: In feet or legs.
Erectile dysfunction: Particularly in men with severe PVD.

Diagnosis

The diagnosis of PVD involves a combination of patient history, physical examination, and diagnostic tests. These include:

Ankle-Brachial Index (ABI): A non-invasive test comparing blood pressure in ankle with in the arm. A lower ABI indicates narrowed arteries.
Ultrasound: To visualize blood flow and identify blockages.
Angiography: A procedure that involves injecting a contrast dye into the blood vessels to take detailed images using X-rays or MRI.
Blood tests: To check cholesterol and glucose levels.

Treatment

Treatment for PVD focuses on managing the symptoms, slowing progression, and improving quality of life. Approaches include:

Lifestyle Changes:

Quitting smoking: One of the most effective ways to slow disease progression.
Exercise: Regular physical activity can improve circulation also reduce symptoms.
Healthy diet: A diet low in saturated fats, cholesterol, and salt can help control cholesterol and blood pressure.
Weight management: To reduce stress on the arteries and improve overall health.

Medications:

Antiplatelet drugs (e.g., aspirin or clopidogrel): To reduce the risk of blood clots.
Statins: To lower cholesterol and reduce plaque buildup.
Blood pressure medications: To control hypertension.
Medications to manage diabetes: If applicable, to keep blood sugar in check.
Medications to improve blood flow: For instance, cilostazol to help alleviate claudication pain.

Procedures:

Angioplasty and Stenting: A minimally invasive procedure where a balloon is used to open up narrowed arteries, and a stent is placed to keep them open.
Bypass surgery: In severe cases, where a blood vessel is bypassed using a graft to restore blood flow.
Endarterectomy: A surgical procedure to remove the plaque from the affected artery.

Complications

PVD can lead to serious complications

Critical limb ischemia: A severe blockage of blood flow, leading to chronic pain, ulcers, or gangrene, which may require amputation.
Heart attack or stroke: Because PVD often coexists with atherosclerosis in other areas, there’s a higher risk of heart attack and stroke.

Prevention

Preventing PVD involves managing risk factors:

Avoid smoking.
Exercise regularly.
Eat a balanced, heart-healthy diet.
Control blood sugar, blood pressure, and cholesterol.