What is Peripheral Vascular disease?
Peripheral Vascular disease (PVD) refers to diseases of blood vessels outside the heart and brain. It’s often a narrowing of vessels that carry blood to leg and arm muscles. There are two types of these circulation disorders:

• Functional peripheral vascular diseases don’t have an organic cause. They don’t involve defects in blood vessels’ structure. They’re usually short-term effects and can come and go. Raynaud’s disease (or Raynaud’s phenomenon) is an example. It can be triggered by cold temperatures, emotional stress, work with vibrating machinery or smoking.
• Organic peripheral vascular diseases are caused by structural changes in the blood vessels, such as inflammation and tissue damage. Peripheral artery disease is an example. It’s caused by fatty buildups in arteries (atherosclerosis).

What is Peripheral Artery disease?
Peripheral Artery disease (PAD) is a condition similar to coronary artery disease and carotid artery disease. In PAD, fatty deposits build up along artery walls and affect blood circulation, mainly in arteries leading to the legs and feet. In its early stages, a common symptom is cramping or fatigue in the legs and buttocks during activity. Such cramping subsides when the person stands still. This is called “intermittent claudication.” People with PAD have a higher risk of death from stroke and heart attack, due to the risk of blood clots.

Whereas the central blood vessels are those leading directly to or from the heart, peripheral blood vessels are those in the feet, legs, lower abdomen, arms, neck or head. The term peripheral vascular disease refers to damage or dysfunction within peripheral blood vessels. There are two types of peripheral blood vessels: 1) peripheral arteries, which carry oxygen-rich blood to the extremities and 2) peripheral veins, which carry oxygen-poor blood from the extremities back toward the heart.

There are two types of peripheral vascular disease. The first type is peripheral arterial disease (PAD), which refers to diseased peripheral arteries. Peripheral arterial disease is a type of atherosclerosis, in which the arteries become hardened and narrowed. There are several types of peripheral arterial disease, including:

• Carotid artery disease. Narrowing of on or more carotid arteries in the neck, which supply oxygen-rich blood to the brain.
• PAD of the lower extremities (legs). Narrowing of one or more arteries in the leg (usually the femoral artery near the groin).
• PAD of the renal arteries. Narrowing of one or more renal arteries, leading to the kidneys.
• Abdominal aortic aneurysm (AAA). The bulging or ballooning out of part of the wall of the abdominal aorta, a section of the blood vessel that carries oxygen-rich blood from the heart to the body.
• Raynaud syndrome. A reversible condition in which the fingers or toes start throbbing and turning a whitish color because a contraction (vasospasm) of the small arteries has interfered with blood flow.
• Buerger disease. A rare type of peripheral arterial disease that involves inflammation of the smaller arteries in the extremities that gets worse over time causing increasing pain in their legs (claudication).
• Polyarteritis nodosa (PN). A rare and potentially deadly form of vasculitis – a condition in which small to medium-sized blood vessels (usually arteries) are abnormally inflamed. PN causes structural damage to the inside walls of the inflamed blood vessels, which reduces the flow of blood through them.

The second type of peripheral vascular disease is peripheral venous disorders, which refer to problems in the peripheral veins. There are a number of different peripheral venous disorders, which include the following:

• Thrombophlebitis (including superficial vein thrombosis and deep vein thrombosis). An obstructing blood clot (a thrombus) has formed, causing the surrounding veins to become inflamed (phlebitis).
• Varicose veins. Abnormally widened veins that are swollen, dark and frequently twisted or contorted instead of straight. They usually occur in the legs, and may cause swelling (edema), inflammation and a dark color around the ankles.
• Chronic venous insufficiency. An advanced stage of leg vein disease in which the veins become incompetent, causing blood to pool in the legs and feet, and sometimes to leak backwards.

Advances in the diagnosis of a vascular disease include the plethysmogram and the venogram. Modern medical techniques to repair diseased veins include the use of lasers, sclerosing agents and endoscopic vein surgery. For more information, please click on any of the links in this article.







How is Peripheral Artery disease diagnosed and treated?
The techniques used to diagnose PAD are similar to those used to diagnose carotid artery disease and cardiovascular disease. They include Doppler ultrasound, X-ray angiography and magnetic resonance imaging (MRI).

PAD is treated with drugs called “antithrombotics.” These medicines prevent blood from clotting. Two types of anti-thrombotics are anti-platelet agents and anticoagulants.

A type of angioplasty can be used to dilate narrowed peripheral arteries. Often a stent is used to hold the artery open.

A type of surgery for PAD involves bypassing the diseased part of the artery. A vein from another part of the body or a synthetic blood vessel is used. Another surgical procedure is endarterectomy. In this case, the diseased vessel is cut open and the fatty deposit is removed.