Peripheral Vascular Disease (PVD)
Sutter Heart & Vascular Institute

What is Peripheral Vascular Disease (PVD)?
PVD refers to diseases of blood vessels outside the heart and brain. It is a slow progressive blood disorder that consists of a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys. Peripheral Artery Disease (PAD) is a form of PVD which refers to slow circulation in the legs. The terms PVD and PAD are often used interchangeably.

The narrowing of the blood vessels causes blockages in leg arteries which result in painful symptoms including: leg pain, sores on your foot or leg that don’t heal (ulcers), leg discoloration, and sometimes amputation.

What are the causes PVD / PAD?
The most common cause PVD is atherosclerosis (the buildup of plaque inside the artery wall). Plaque build up 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.

How do you know if you are at high risk of getting PVD / PAD?
There are many risk factors that contribute to or cause PVD & PAD. Some of those risk factors are:

• Age (older then 50)
• Male
• Type 1 Diabetes (diabetes mellitus)
• Postmenopausal women
• Coronary artery disease
• Impaired glucose tolerance
• Dyslipidemia (elevated lipids in the blood, such as cholesterol)
• Hypertension (high blood pressure)
• Obesity
• Physical inactivity
• Smoking or use of tobacco products
• Family history of heart disease, dyslipidemia, hypertension, and peripheral vascular disease

What are the symptoms of PVD / PAD?
Approximately half the people diagnosed with peripheral vascular disease are symptom free. 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:

• Pain in the legs (described as burning or aching) at rest, commonly in the toes and at night while lying flat
• Changes in the skin, including decreased skin temperature, or thin, brittle shiny skin on the legs and feet
• Diminished pulses in the legs and the feet
• Gangrene (dead tissue due to lack of blood flow)
• Hair loss on the legs
• Ulcers (non-healing wounds over pressure points, such as heels or ankles)
• Numbness, weakness, or heaviness in muscles
• Pallor (paleness) when the legs are elevated
• Reddish-blue discoloration of the extremities
• Restricted mobility
• Severe pain in the leg
• Thickened, opaque toenails

What are the treatment options for PVD / PAD?
The treatment options for PVD & PAD can be broken up into two groups: nonsurgical and surgical.

Nonsurgical treatment

• Lifestyle changes – modifications in your everyday lifestyle like regular exercise, proper nutrition, and smoking cessation. Lifestyle changes can help, but it will not fix the damage already done.
• Treat the attributing conditions – certain conditions such as diabetes, hypertension, and hyperlipidemia which aggravate PVD & PAD. Aggressively treating these conditions can help, but it will not fix the damage already done.
• Medications - for improving blood flow, such as antiplatelet agents (blood thinners) and medications that relax the blood vessel walls are used to treat the symptoms, but will not fix the damage already done.

Surgical treatment

• Angioplasty – A surgical procedure in which a small catheter is inserted in to an artery to increase blood flow Read more about Angioplasty…
• Vascular Surgery – Also referred to as bypass surgery uses a blood vessel from another part of the body or a tube made of synthetic material is placed in the area of the blocked or narrowed artery to reroute the blood flow Read more about Vascular Surgery…
• Diamondback 360 ° ™ Procedure – A minimally invasive surgical procedure using a new tool known as the Diamondback 360 ° ™ which uses a small diamond-coated crown which rapidly spins or orbits at high speeds to sand away plaque, while preserving the healthy tissue of the arterial wall. Read more about Dimaondback…