condition
Peripheral vascular disease
Peripheral vascular disease (PVD) is a disorder of the blood circulation that causes your vessels to become narrow and get blocked, thereby reducing the blood flow to organs. It most commonly affects the lower legs and feet.
PVD is usually caused by the build-up of fatty deposits inside the walls of arteries and veins that supply the leg muscles. Infection and injury can also cause damage.
If just the arteries are affected, it’s sometimes referred to as peripheral arterial disease.
What can you find here?
What causes PVD and why the worry?
There are certain factors that cause damage to all blood vessels, including those vessels supplying the legs, the heart, the brain and the kidneys.
Smoking is the biggest risk factor for this condition. Certain medical problems can affect blood vessels over time, including diabetes Type 1 and Type 2, high cholesterol and high blood pressure. Obesity and heart disease, or any close family member with heart disease, also add to your risk.
You are higher risk as you age, especially those over 50 years old, and it’s more common in men and post-menopausal women.
Uncontrolled and untreated PVD can increase your chance of developing coronary artery disease, which can cause heart attacks, and critical limb ischaemia, which requires urgent medical attention to avoid needing an amputation.
What are the symptoms?
There are certain factors that cause damage to all blood vessels, including thsoe vessels supplying the legs, the heart, the brain and the kidneys.
Smoking is the biggest risk factor for this condition. Certain medical problems can affect blood vessels over time, including diabetes Type 1 and Type 2, high cholesterol and high blood pressure. Obesity and heart disease, or any close family member with heart disease, also add to your risk.
Ageing puts you at higher risk, especially over 50 years old, and it’s more common in men and post-menopausal women.
Uncontrolled and untreated PVD can increase your chance of developing coronary artery disease, which can cause heart attacks, and critical limb ischaemia, which requires urgent medical attention to avoid needing an amputation.
What will my doctor do?
Your doctor will ask about your symptoms and go through any risk factors with you. They may have a look at the legs and have a listen to your heart and they’ll take your blood pressure.
You may be sent for blood tests to check your cholesterol and sugar levels for diabetes. They may refer you for further investigations to look closer at the pressure and blood flow in your vessels. Doppler ultrasounds assess the flow of blood in the veins, and they can measure the blood pressure of the arteries in each leg using an ankle brachial pressure index (ABPI).
You may be sent for an angiogram, where contrast dye is injected into an artery and x-ray images are taken to identify any blockages.
To understand how your symptoms are affected by activity you may be asked to do a treadmill test, where you walk on a treadmill while your doctor assesses your circulation.
How is PVD treated?
The first thing is to address the risk factors that you can do something about, such as stopping smoking and losing any excess weight. You can also change your diet and exercise to help improve any diabetes, high blood pressure or high cholesterol. Your doctor may also prescribe medications for this.
Sometimes medication to thin your blood may also be offered such as aspirin to prevent against a blood clot forming.
Naftidrofuryl oxalate is another medication that can sometimes be used to improve the blood flow if you have leg pain on walking, but this is started by a specialist.
Surgery may be required to restore the blood flow and this is dependent on the severity of your symptoms and the findings of the investigations. During an angioplasty a small balloon is inflated inside the vessel to keep it open and an artery bypass graft uses an artery from elsewhere in the body to create a bridge to bypass the blockage.
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