Peripheral Vascular Disease
What is Peripheral Vascular Disease?
Peripheral Vascular Disease (PVD) is narrowing of blood vessels supplying the blood flow to the limbs. The narrowing is because of hardening of arteries caused by cholesterol deposits within the arterial wall.
What is the significance of PVD?
PVD is a generalized disease process. If you have PVD, there is high likelihood that you may have disease in blood vessels supplying heart and brain putting you at significant potential risk of heart attack and stroke
What are the symptoms of PVD?
In the initial stages, the disease is not symptomatic. One of the first sign of peripheral vascular disease is difficulty in walking called intermittent claudication. Patients complain of pain in leg on walking with relief from pain on stopping. As the disease progresses, the pain becomes constant even at rest. Eventually, disease leads to ulcers or gangrene in the legs requiring amputation. In extreme cases, gangrene of legs can be life threatening
Who is at risk?
Patients with known heart disease and stroke are at high risk of getting peripheral vascular disease as the underlying disease pathology is similar.
One of the groups of patients at particular risk in our local population is patients with diabetes. Other risk factors include smoking, hypertension, high cholesterol, and patients with renal failure.
How do you diagnose PVD?
In the early stages, one of the screening tests is a simple non-invasive test called Ankle Brachial Index (ABI) measurement. This involves measuring blood pressure in the arm and leg simultaneously. With advanced disease, other non-invasive tests like ultrasound, CT or MRI scan are used for disease assessment.
How do you treat PVD?
One of the first things done in patients with PVD is to control their risk factors well with proper medical management such as controlling diabetes, hypertension, high cholesterol etc.
For significant symptoms, further management options are open surgery or minimally invasive endovascular treatment which is angioplasty and stent placement. Minimally invasive methods of treatment such as angioplasty are now becoming extremely popular, as they are as effective as surgery with shorter recovery times. For a significant number of patients, this can be done as a day procedure with discharge from the hospital on the same day.
What are the latest treatment procedures for PVD?
There are significant recent advances in minimally invasive treatment of PVD. These include drug coated balloons, drug delivery balloons, drug eluting stents, mechanical thrombectomy devices, as well as devices to remove clots. These enable us to treat patients more effectively than was possible few years back with reduction in risk of recurrent disease