WHAT IS PERIPHERAL VASCULAR DISEASE?
Peripheral vascular disease (PVD) is also known as peripheral artery disease (PAD), or leg artery disease, and affects nearly 10 million people in the U.S. alone. The arteries affected by PAD provide blood supply to the legs. When these arteries are partially or completely blocked, they can cause a great deal of pain during physical activity or even at rest. The primary cause of PAD is atherosclerosis, which is a condition that develops when fatty plaque builds up along the walls of an artery, inhibiting blood flow to the extremities. This plaque is made up of fats, cholesterols and other substances that compose a hard residue on the lining of the arteries.
Other, less common, causes include vasculitis (inflammation of the blood vessels); injuries (sports or auto accidents) that could affect the blood vessels; blood clotting diseases and abnormalities of the blood vessels.
RISK FACTORS FOR PERIPHERAL ARTERY DISEASE
While PAD is a common condition, certain people are at a greater risk than others. Risk factors include:
- Physical inactivity
- Chronic renal failure
- Obesity (body mass index over 30)
- High cholesterol and blood pressure
- Age and family history of heart disease
CAUSES OF PERIPHERAL ARTERY DISEASE
PAD often goes untreated for years because people do not know the symptoms or mistake them for something else. The primary symptom of PAD is cramping in the calf or thigh with activity that improves with rest (intermittent claudication).
When PAD is more severe, other symptoms include:
- Numbness and weakness in extremities
- Coldness in legs or feet
- Weak or no pulse in legs and feet
- Discoloration of feet
- Sores on feet and toes that will not heal or heal slowly
- Slow toenail growth
- Erectile dysfunction (in men)
DIAGNOSIS AND TREATMENT OF PERIPHERAL ARTERY DISEASE
PAD can be painlessly diagnosed with a routine physical with our experienced medical staff. Noninvasive tests, such as ankle-brachial index (ABI) and doppler ultrasound, may also be performed to help to make a diagnosis.
If the ultrasound suggests that there is significant narrowing or blockage of the arteries of the legs, an angiogram may be recommended as the next diagnostic test. In this procedure, a thin catheter is inserted into the arteries of the legs. Contrast (xray dye) is injected, and pictures are taken of those blood vessels. The exact location of the narrowings or blockages can be precisely identified, and a treatment plan can be designed based upon those findings. At CFIM, we carefully formulate a treatment plan with the input of the patient and their family.
Treatment aims to (1) reduce the pain associated with PAD and (2) decrease the progression of atherosclerosis, thereby improving the ability to perform activities and preventing ulcers and loss of tissue. If the abnormalities and symptoms are not severe, a medication may be prescribed first, to try to medically improve the circulation.
If the abnormalities are more severe, minimally invasive treatments to open up blocked arteries include:
- Angioplasty, which involves using a small thin balloon at the end of a catheter to open up a narrowing.
- Stent placement, which is a thin wire mesh tube that props open an artery to prevent it from closing again.
- Atherectomy, which is done using a device like a “roto-rooter”, to clean out fatty plaque buildups.
- Thrombolysis, which involves injection certain powerful “clot buster” medications to break up clot.
Sometimes, these minimally invasive treatments are not advised because the problem is too severe, and in that case, surgical bypass may be advised.
The physicians and staff at CFIM are among the most experienced in the entire region at performing these minimally invasive procedures, so that you can get back to your normal activities and enjoy life as soon as possible! Call us today to schedule a free screening for this and other conditions at a CFIM office in northern Virginia (convenient to Springfield, Fairfax, Alexandria, Arlington, Woodbridge) or Maryland (convenient to Waldorf, La Plata, Clinton).