What is it?

Peripheral Vascular Disease (PVD) is caused by buildup of plaque (atheroma) in the lumen of the artery (the channel where blood flows). This is commonly known as atherosclerosis or arteriosclerosis (hardening of the arteries). When the channel of blood flow becomes blocked, the muscles beyond the blockage do not get enough blood and oxygen to support activity.

How do I know if I have pvd?

Patients often complain of trouble walking and climbing stairs. The symptoms are described as: cramping, aching, and heaviness often relieved by standing still or resting. This is known as claudication and is caused by the muscles being starved for oxygen due to the blockages in the artery. Does everyone with these symptoms have PVD? No. There are other conditions which can cause similar complaints such as diabetes, arthritis and spinal disease (such as herniated disc).

What if I think I have pvd?

First see your doctor. He/she may try to feel pulses in your legs and feet. Often they will be absent. You may then be scheduled for a Doppler test. The purpose of this test is to determine whether or not you have significant PVD and be sure there are no other causes likely to cause your symptoms. The test is painless-just like having a blood pressure taken on your arm.

What then?

You may then be scheduled to see a vascular specialist who will talk at length with you and review any appropriate studies. There are different treatment plans which will be discussed with you depending on the severity of disease and other factors. If further work-up is decided upon, an angiogram will be necessary. This is ordered to give us more information to offer you the best solution to the problem.

What are the options?

There are many times when surgery will not be advised. However, if intervention is agreed upon by the surgeon and patient, several options exist. Traditionally, bypass surgery has been the standard treatment. This essentially places a new blood vessel in place of the old so improved blood flow occurs. However, there are other choices for certain types of blockage. Angioplasty and stent placement can accomplish almost the same result as bypass with less hospital time and shorter recovery time.

Balloon angioplasty is done by making a small entry in the femoral artery and placing a wire through the blockage, followed by a balloon. When the balloon is inflated, the plaque is compressed, often leading to a near normal appearing artery. At times, a stent is placed at the site of angioplasty to give better results. There are situations where angioplasty and stent placement are not suitable and therefore, this is not an option for all patients. Your surgeon will discuss all these options with you before a final decision is made.

Are there forms of pvd which are more severe?

Yes. When the blockages are more diffuse, patients describe pain in the feet and toes (rest pain) and may have non-healing foot ulcers. When this occurs, the threat of limb loss and amputation are significant and urgent evaluation is necessary. Many times, significant improvement can be achieved with either bypass or angioplasty and stenting, but there are cases where the disease is so widespread that no treatment will be successful.

What type of recovery can I expect?

Most patients who undergo successful bypass are in the hospital 4-7 days and need a few weeks of recovery before resuming normal activities. Patients who undergo balloon angioplasty or stenting are hospitalized overnight and resume normal activity much sooner.

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