Peripheral Vascular Disease
Peripheral vascular disease (PVD) refers to conditions that primarily affect the arteries of the body, with the exception of the coronary arteries that supply blood to the heart. Those are covered in the article on cardiovascular disease. The most common areas for PVD are the arteries of the legs and upper arms, the carotid (neck) arteries, the abdominal aorta and its branches, and the renal (kidney) arteries. Conditions affecting the veins, such as chronic venous insufficiency, varicose veins, and hemorrhoids, are not usually included in PVD.
A major cause of stroke is PVD of the carotid arteries. Intermittent claudication refers to pain in the lower legs after walking short distances and is caused by PVD of the leg arteries. One cause of erectile dysfunction may be PVD of the penis. Raynaud’s disease is a painful condition caused by spasms of arteries after exposure to cold. The cause of most types of PVD is atherosclerosis (hardening of the arteries), which itself has many causes.
Thromboangiitis obliterans (TAO), also known as Buerger’s disease, is an uncommon PVD that occurs in both arteries and veins. This condition causes tender areas of inflammation in the arms or legs, followed by cold hands or feet. Intermittent claudication is another common symptom.
Aneurysm is a ballooning of an artery due to weakening of the blood vessel walls. Aneurysms may be an inherited disorder or may be due to atherosclerosis. The most common aneurysm is abdominal aortic aneurysm (AAA), which occurs in the large artery that carries blood from the heart to the lower body. AAA is much more common in men, and risk increases with age. Large AAAs are usually surgically repaired because they can undergo life-threatening ruptures.
What are the symptoms of peripheral vascular disease?
People with peripheral vascular disease may have symptoms of pain, aching, cramping, or fatigue of the muscles in the affected leg that are relieved by rest and worsened by elevation. Other people with peripheral vascular disease may have swollen feet and ankles accompanied by a dull ache made worse with prolonged standing and relieved by elevation. People with chronic peripheral vascular disease may have darkened areas of skin, leg ulcers, and varicose veins.
How is it treated?
Conventional treatment may include antiplatelet and cholesterol lowering drugs in combination with anti-claudication medications, such as cilostazol and pentoxifylline. Exercise rehabilitation therapy, weight loss, and smoking cessation are often recommended. Surgical options to restore blood supply called revascularization procedures are usually reserved for those with progressive or disabling symptoms. For some people, doctors advise elevating the legs frequently, avoiding prolonged standing or sitting, and wearing graduated compression stockings with supportive shoes. Any ulcers that develop are treated with compressive bandages that contain antibiotic solutions. Recurrent ulceration may be surgically treated with skin grafts and repair or bypass of the affected veins.
Lifestyle changes that may be helpful:
People with TAO are usually heavy smokers, and this is considered a major cause of the disease. It is important for people with TAO to quit smoking.
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