What Is Peripheral Vascular Disease?
Peripheral vascular disease (PVD) is a slow and progressive circulation disorder that affects the arteries, veins and lymphatic vessels outside of the heart and brain, causing narrowing, blockages or spasms in these blood vessels. As a result, organs and muscles supplied by these vessels—such as the brain or legs—may not get enough blood flow to function properly.
When peripheral vascular disease affects only arteries, it is referred to as peripheral arterial disease (PAD). PAD most often affects the legs.
The most common cause of PVD is atherosclerosis, the buildup of plaque inside the blood vessel wall. Blood clots also may form on the blood vessel walls, further decreasing the inner size of the blood vessel and blocking blood flow.
Other causes of PVD may include:
- Injury to the arms or legs
- Irregular anatomy of muscles or ligaments
- Infection
Importantly, surgeons in the Division of Vascular and Endovascular Surgery at Cooper University Health Care have extensive experience and expertise in treating PVD.
Why Choose Cooper to Treat Peripheral Vascular Disease?
Our vascular and endovascular surgeons are nationally recognized experts in diagnosing and treating peripheral vascular disease. Because we see so many patients with this condition, we have a depth of experience that is unrivaled in South Jersey.
Also importantly, Cooper is a high-volume center for lower-extremity limb salvage procedures, highly specialized surgical interventions to avoid the need for amputation. Our team is part of the only program in the region dedicated to limb salvage that combines open surgical and endovascular procedures. This expertise has enabled us to save the limbs of hundreds of patients with severe blockages in their blood vessels.
With a comprehensive array of treatment options, including minimally invasive endovascular techniques, we are able to tailor the best approach for each patient’s unique situation.
Risk Factors for Peripheral Vascular Disease
These factors can increase your risk of having peripheral vascular disease:
- Age (especially older than age 50)
- Male gender
- Postmenopausal women
- Family history of high cholesterol, high blood pressure, or peripheral vascular disease
- Coronary artery disease
- Diabetes
- High cholesterol
- High blood pressure
- Overweight
- Physical inactivity
- Smoking or use of tobacco products
Peripheral Vascular Disease Symptoms
About half the people diagnosed with PVD are symptom-free. For those with symptoms, the most common one is painful leg cramping that occurs with exercise and is relieved by rest (what’s called intermittent claudication). The pain often leads to restricted mobility.
Other symptoms of PVD may include:
- Changes in the skin, including decreased skin temperature, or thin, brittle, shiny skin on the legs and feet
- Weak pulses in the legs and the feet
- Hair loss on the legs
- Impotence (erectile dysfunction)
- Numbness, weakness, or heaviness in muscles
- Pain (described as burning or aching) at rest, commonly in the toes and at night while lying flat
- Paleness when the legs are elevated
- Reddish-blue discoloration of the extremities
- Thickened, opaque toenails
Left untreated, PVD can lead to complications such as:
- Poor wound healing and gangrene (dead tissue)
- Amputation (loss of a limb)
- Stroke, which is three times more likely in people with PVD
How Peripheral Vascular Disease Is Diagnosed
Along with a complete medical history and physical exam, your doctor may perform diagnostic tests such as:
- Angiogram: An x-ray of the arteries and veins to detect blockages or narrowing; it involves inserting a thin, flexible tube into an artery in the leg and injecting a contrast dye, which makes the arteries and veins visible on the x-ray
- Ankle-brachial index (ABI): A comparison of the blood pressure in the ankle with the blood pressure in the arm using a regular blood pressure cuff and a Doppler ultrasound device
- Doppler ultrasound: Uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs, and help your doctor measure and assess blood flow
- Magnetic resonance angiography (MRA): This noninvasive test uses a large magnet, radiofrequencies, and a computer to produce detailed images of organs and structures in the body; your doctor injects a special dye during the procedure so that blood vessels are more visible
- Treadmill exercise test: For this test, you walk on a treadmill so your doctor can monitor blood circulation during exercise
- Photoplethysmography (PPG): This exam is comparable to the ankle brachial index, but it uses a tiny blood pressure cuff around the toe and infrared light to evaluate blood flow near the surface of the skin
- Pulse volume recording (PVR) waveform analysis: Your doctor uses this technique to calculate blood volume changes in the legs using a special recording device
- Reactive hyperemia test: This test is similar to an ABI or a treadmill test but used for people who can't walk on a treadmill.
How Peripheral Vascular Disease Is Treated
The main goals for treating PVD are to control the symptoms and halt the progression of the disease in order to lower the risk for heart attack, stroke, and other complications.
Treatment may include:
- Lifestyle changes to control risk factors, including regular exercise, proper nutrition, and quitting smoking
- Aggressive treatment of existing conditions that may worsen PVD, such as diabetes, high blood pressure, and high cholesterol
- Medicines to improve blood flow, such as antiplatelet agents (blood thinners) and medicines that relax the blood vessel walls
- Vascular surgery: Usually a bypass graft in which a blood vessel from another part of the body or a tube made of synthetic material is placed in the area of the blocked or narrowed artery to reroute blood flow
- Angioplasty: Your doctor inserts a catheter to create a larger opening in an artery to increase blood flow. There are several types of angioplasty procedures, including:
- Balloon angioplasty: A small balloon is inflated inside the blocked artery to widen the area
- Atherectomy: The blocked area inside the artery is "shaved" away by a tiny device on the end of the catheter
- Laser angioplasty: A laser is used to "vaporize" the blockage in the artery
- Stent: A tiny coil is expanded inside the blocked artery and left in place to keep the artery open
Contact Us Today About Your PVD Treatment
To learn more about the services available in the Division of Vascular and Endovascular Surgery or to schedule an appointment, please call 856-342-2151.
Refer a Patient
If you are a doctor who wants to refer a patient to the Division of Vascular and Endovascular Surgery, please call 856-968-7067.