Peripheral Vascular Disease

Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels — the arteries, veins or lymphatic vessels. Organs such as the brain, heart and legs may not receive adequate blood flow for ordinary function. The legs and feet are most commonly affected.

PVD often involves the narrowing of vessels that carry blood to the legs and arms. The most common cause is atherosclerosis (the buildup of plaque inside the artery wall). Plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue. Clots may form on the artery walls, potentially blocking off major arteries.

To determine whether you have PVD, diagnostic procedures may be performed, including:

• Angiogram: A thin tube is placed in an artery in the leg and injected with a contrast dye, making the veins visible on an x-ray
• Ankle-brachial index (ABI): Comparing the blood pressure in the ankle with the blood pressure in the arm
• Blood lipid profile: A blood test to measure the levels of different fats in the blood
• Doppler ultrasound flow studies: High-frequency sound waves are used to create images of blood vessels, tissues and organs and to assess the blood flow
• Magnetic resonance angiography: A magnet, radio frequencies and a computer are used to produce detailed images of organs
• Treadmill exercise test: The heart is monitored while a patient walks on a treadmill
• Photoplethysmography: Similar to an ABI, except it uses a tiny blood pressure cuff on the toe and a sensor to record blood pressure measurements. The measurements are compared to the arms systolic blood pressure
• Segmental blood pressure measurements: Comparing blood pressure in the upper thigh, above and below the knee, at the ankle and on the arm

Treatments may include aggressive treatment of existing conditions that may aggravate PVD, such as diabetes and hypertension, medications for improving blood flow, such as blood thinners, and medications that relax the blood vessel walls. Physicians may also choose to perform a type of angioplasty to widen the arteries or vascular surgery.

Peripheral Arterial Disease

When PVD occurs in the arteries outside the heart, it may be referred to as peripheral arterial disease (PAD). Peripheral vascular disease and peripheral arterial disease are often used interchangeably. It is frequently found in people with coronary artery disease because atherosclerosis is a widespread disease of the arteries.