Peripheral Vascular Disease


Peripheral Vascular Disease (PVD) is a condition where blood vessels outside the heart and brain, particularly in the arms and legs, become narrowed or blocked.
This often happens due to peripheral atherosclerosis, which is the buildup of fatty deposits in the artery walls.
Over time, reduced blood flow can cause discomfort and complications, especially in the legs, feet, and other peripheral areas.
PVD disease includes two types: Peripheral Arterial Disease (PAD), which affects the arteries, and Peripheral Venous Disease, which impacts veins.
PAD occurs when arteries are blocked or narrowed, reducing oxygen-rich blood flow to the limbs.
Venous disease, by contrast, involves issues like varicose veins or clotting that hinder blood return to the heart.
PVD often progresses silently, but as the condition worsens, symptoms become more noticeable. Common symptoms include:
- Claudication symptoms, such as leg cramping or pain while walking that eases with rest.
- Numbness, weakness, or a cold sensation in the legs and feet (referred to as PVD legs or PAD legs).
- Slow-healing wounds or ulcers, especially on the feet or toes, caused by reduced blood flow.
- Skin discoloration or shiny skin on the lower limbs, indicating arterial dysfunction.
If left untreated, PVD can lead to more severe complications, including tissue death or, in extreme cases, amputation due to lack of blood supply. If you notice these signs, it’s essential to consult a specialist.
The leading cause of PVD is peripheral atherosclerosis, where fatty deposits block the arteries. Other factors contributing to arterial issues include:
- High blood pressure and high cholesterol, which strain and damage blood vessels.
- Smoking, which accelerates arterial damage.
- Diabetes, which contributes to both PAD vascular complications and venous disease.
- Genetic conditions like arterial disease examples of Marfan Syndrome or Ehlers-Danlos Syndrome.
PVD is more likely to develop in people over 50, especially if they have a history of smoking or high blood pressure.
Diagnosing PVD disease typically involves a combination of clinical evaluation and imaging tests. These may include:
- Ultrasound scans, particularly useful for detecting blockages in the legs or arms.
- CT or MRI scans, helpful for diagnosing advanced cases of peripheral vasculopathy.
- Ankle-brachial index (ABI), a test comparing blood pressure in your ankle and arm to detect blockages.
Your vascular specialist may also assess blood flow and overall circulation using advanced diagnostic tools, especially if you present symptoms like arterial claudication or vascular problems in feet.
Intermittent claudication is a common symptom of PVD disease (Peripheral Vascular Disease), affecting blood flow to the legs.
It manifests as pain, cramping, or fatigue in the PAD legs, particularly during physical activities like walking or exercise.
The discomfort typically subsides with rest.
This condition arises when blood flow to the muscles is restricted due to PAD artery blockages, often caused by peripheral atherosclerosis.
According to AVC’s Dr Jason Toniolo: “The narrowing of arteries reduces the oxygen supply to the leg muscles, which causes pain during exertion.”
These restrictions are common in PAD vascular and PVD legs.
The severity and location of the pain can vary. Most often, it affects the calves, but depending on the blockage’s location, it can extend to the thighs or buttocks.
Critical Limb-Threatening Ischaemia (CLTI) is a severe form of PAD disease where blood flow is so restricted that the limb’s survival is at risk.
Dr Toniolo explains: “CLTI represents a point where blood flow is critically low, and immediate intervention is necessary to preserve the limb.”
Symptoms of PAD disease in this stage include persistent pain at rest, which is typically worse at night when the leg is elevated.
“Patients may find relief when hanging the leg off the bed or sitting up, as gravity helps blood reach the toes,” says Dr Toniolo.
In cases of vascular problems in feet, PAD legs may develop non-healing ulcers or gangrene. If left untreated, it can lead to irreversible tissue damage and even limb loss.
If you notice persistent leg pain that doesn’t improve with rest or experience symptoms like non-healing sores, it’s essential to seek immediate medical attention.
“Early diagnosis and treatment can prevent serious complications, including amputation,” says Dr Toniolo.
Understanding the seriousness of PVD symptoms, including claudication symptoms, can help you act quickly.
Arterial claudication treatment options are more effective when started early.
Don’t wait for symptoms to worsen—seek care if you notice any arterial dysfunction or vascular problems in feet.
Immediate care can prevent complications and improve outcomes for individuals experiencing PAD disease.
If you’re experiencing issues related to arterial disease, Peripheral Venous Disease (PVD), or acute PAD, it’s crucial to consult with your healthcare provider to evaluate your condition and determine the best course of treatment.
When it comes to treating PVD disease, two main approaches are typically used: endovascular treatments and open surgical procedures.
Both treatments aim to address vascular problems in feet and improve blood flow, but they differ in invasiveness and recovery time.
Endovascular treatments such as angioplasty, stenting, and atherectomy are minimally invasive procedures designed to address PVD.
These treatments involve using a catheter to treat blockages and are generally effective for treating PVD in many patients.
They offer the advantage of shorter recovery times compared to open surgery, which is why they’re a preferred choice for addressing earlier stages of the disease.
While endovascular procedures are suitable for many, Dr Toniolo explains, “Though these treatments can offer rapid relief, patients with PAD disease may still need PVD treatment again in the future if the blockages return or if claudication symptoms persist.”
Endovascular treatments work best for arterial issues meaning certain locations of arterial narrowing,
especially when the blockage is relatively short.
However, the suitability of these treatments depends on the arterial dysfunction severity, particularly peripheral atherosclerosis affecting the arteries.
For more severe cases, open surgery such as endarterectomy (removal of plaque) or bypass graft surgery is used.
These procedures are more invasive and require longer recovery times, but they provide more durable results for individuals with PVD legs or severe PVD symptoms.
Open surgery is often necessary when peripheral vasculopathy is advanced, and blood flow cannot be restored effectively through minimally invasive treatments.
This is particularly true for PAD legs when when a long-standing blockage is present, especially where aorta blockage to legs is a concern.
The decision on which treatment to pursue for PAD Disease depends on a variety of factors, including the severity of the disease, the patient’s overall health, and the exact location of the blockage.
“Determining the best course of action requires careful evaluation of the extent of arterial claudication treatment options, considering the patient’s medical history and arterial disease examples,” says Dr Toniolo.
Patients with arterial dysfunction or symptoms of peripheral cardiovascular disease should seek medical advice early to prevent further complications such as non-healing ulcers or gangrene, which may occur if left untreated.
Regular check-ups are also essential for patients at risk of PAD vascular conditions, particularly those with double aortic arch or other genetic predispositions.
When it comes to PVD treatment, acting promptly can prevent the progression of PVD disease and help maintain the health of artery in feet.
If you need help for yourself or a loved one with PVD call us today on 02 4226 9333.