Peripheral Vascular Disease

Peripheral Vascular Disease is the result of narrowing that forms within arteries, the blood vessels that carry blood away from the heart. The plaques that cause the narrowing consist of cholesterol that is deposited in the wall of the blood vessel. Peripheral Vascular Disease is associated with similar disease in the blood vessels of the heart and brain, which can cause heart attacks and strokes.

Risk Factors

There are many risk factors for Peripheral Vascular Disease, which include:

  • Age
  • Gender
  • Smoking
  • High Blood Pressure
  • High Cholesterol
  • Diabetes Mellitus
  • Obesity

Symptoms

Peripheral Vascular Disease may be completely asymptomatic, but can be detected with tests such as Ankle-Brachial Index, Exercise test or Peripheral Duplex Scanning.  As the disease progresses, it may cause pain in the calf, thigh or buttock when exercising, which is called intermittent claudication.

As the disease progresses further the symptoms become more severe. They include:

  • Coolness and numbness of the feet
  • Continuous pain in the feet, particularly at night
  • Ulcers that are painful and do not heal
  • Gangrene

Investigations

In order to diagnose, monitor or treat your peripheral vascular disease, you may require one or more of the following tests:

  • Ankle-Brachial Index (link to lab)
  • Exercise Test (link to lab)
  • Duplex Ultrasound (link to lab)
  • Computed Tomographic Angiogram (CTA)
  • Catheter Angiogram

Treatment

The optimal treatment for you will depend on the severity of your symptoms, the extent and distribution of your peripheral vascular disease, and the nature and severity of other medical conditions you may have. Treatment options include:

Non-invasive treatment

  • Regular exercise, such as walking or cycling, optimally for 30 minutes daily
  • Stop Smoking
  • Control of blood pressure, cholesterol and diabetes
  • Good foot and skin care

Endovascular treatment – angioplasty and stenting

Some narrowings or blockages in the arteries can be treated by opening the narrowing with a balloon and placing a metal tube called a stent within the narrowing. This procedure is usually performed under local anaesthetic with some sedation and involves only a small incision in the groin.

Vascular Surgery

Extensive blockages or blockages that come back after previous treatment may require an operation to be successfully treated. Operations that can be performed include:

  • Endarterectomy – the narrowing in the artery is removed and the artery is closed with a patch of vein or prosthetic material
  • Bypass – the narrowing in the artery is bypassed with a vein harvested from the legs or arm, or with a plastic tube