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Peripheral vascular disease (PVD)

Overview

Peripheral vascular disease (PVD) typically refers to long-standing narrowing and/or blockage of the vessels delivering blood to your legs (the arteries). Most cases are caused by atherosclerosis, the same condition that affects the blood vessels of the heart and the brain.

 

Symptoms

The majority of PVD patients experience cramping and pain in the lower leg muscles while walking, which is relieved by stopping (this is known as intermittent claudication). In more severe cases, patients may experience pain whilst resting. The most severe type of PVD causes ulcers in the feet or death of the skin (gangrene).

 

Diagnosis

Your doctor will diagnose you by measuring the blood pressure in your legs and comparing the pressure to that in your arms (known as the ankle/brachial index or ABI). You may need to have a picture taken of the blood vessels to document the site and severity of the blockages. This is called an angiogram and can be done using imaging techniques such as CT or MRI. You may also require a test called a digital subtraction angiography (DSA), which involves putting dye directly into your blood vessels.

 

Treatment

The initial treatment you will be given is based on your lifestyle and management of risk factors, such as walking programmes, stopping smoking and controlling diabetes.

If these methods do not help you, the blockages may need to be opened. Minimally invasive approaches (also known as endovascular approaches) use tiny balloons and stents to restore blood flow through a very small hole in the artery. Another possible treatment is surgery, which can either clean out the inside of the artery (a procedure called endarterectomy) or bypass the blockage using a vein or prosthetic material.