Peripheral Vascular Disease
Peripheral vascular disease (PVD) refers to blockages of the arteries outside of the heart composed of cholesterol plaques. As the condition progresses, patients frequently experience intolerance to walking because of discomfort or weakness in the legs. Worsening of the disease may result in pain at rest or sores in the legs. Ultimately, a person might require amputation of the affected limb.
PVD is more common with increasing age, in smokers, and in diabetic patients. Simple, painless and inexpensive non-invasive tests can be performed in the office to detect the condition. Further evaluation may require advanced (CT or MRA) imaging. Catheter-based angiography may also be necessary to define the extent and severity of the disease.
PVD is typically first treated with risk factor modification: smoking cessation, cholesterol lowering therapy, aspirin and possible other medications. A search for other organs affected by cholesterol plaques may be indicated. Rehabilitation is recommended for PVD patients, and may be the only form of treatment needed.
Medications may help alleviate symptoms related to PVD. Patients who have inadequate relief with conservative management or who are at risk for sores or limb loss are frequently evaluated with the goal of aggressively improving blood flow.
Surgery was once the only therapy available to achieve this goal. Now, minimally invasive therapy, including balloon angioplasty and stent implantation, has great success for many patients. This is typically an outpatient procedure that offers immediate relief for many patients.
