Peripheral Vascular Disease Defined
Peripheral Vascular Disease (PVD) causes the blood vessels in the legs, abdomen, pelvis, arms, or neck to become narrowed or blocked. PVD most commonly affects leg arteries or the arteries in the abdomen and pelvis that lead to the legs.

Who is at Risk?
The more risk factors a person has, the more likely he or she will develop PVD. The risk factors for PVD include:

• Smoking
• High cholesterol
• Heart disease
• Diabetes
• Obesity
• Hypertension
• Family history

How Can Arterial Disease be Controlled or Prevented?
We cannot cure or prevent PVD, but we can control certain risk factors by changing our health habits:

Smoking: Tobacco in any form should be avoided. Nicotine causes the blood vessels to constrict, which prevents the normal amount of blood from reaching the organs and extremities, and increases the risk of atherosclerosis. Smoking also decreases the amount of oxygen in the blood, and may be associated with blood clot formation.

Diet: By reducing cholesterol and saturated fats in the diet, you may reduce the risk of atherosclerosis. Hypertension: Untreated high blood pressure adds to the work load of the heart and creates stress on the arteries. Have your blood pressure checked regularly and take medications as ordered by your doctor. Your doctor may suggest stress management classes or a low salt diet.

Diabetes: People with diabetes are especially prone to atherosclerosis. It is important to follow the recommendations of a health care team regarding diet, treatment, and medications.

Exercise: Get regular exercise. Before engaging in any exercise program, consult your physician.

Symptoms of PVD:

• Pain during exercise. (called intermittent claudication)
• Cold and/or numb feet or toes.
• Sores that are slow to heal.
• Leg pain at rest.
• Erectile dysfunction.

Symptoms vary by individual and some people with PVD do not have any symptoms.

Physical Signs of PVD:

• Pale skin of the legs that gets worse with exercise or when the legs are elevated.
• Loss of hair on the feet and toes.
• Redness in the feet and toes when dangling.
• Blue or purple marks on the legs, feet or toes.
• Ulcers on the feet or toes.
• Black skin on the legs or feet that indicates the death of tissue.

A Final Word
Advances in vascular surgery allows for treatment of atherosclerosis with low risk of complications. Surgery may improve or eliminate symptoms but it is not a cure. Keeping follow up appointments and reducing risk factors will help you control further disease.

Exams & Tests
Your doctor may recommend testing for PVD when you have related symptoms. A medical history and physical exam are usually part of an evaluation for PVD. If your doctor suspects you may be at risk for PVD, he or she will likely examine you for any physical signs of the disease. If the history and physical exam suggest that you may have PVD, an ankle-brachial index test or ABI is often the first step to confirm the diagnosis and help determine its severity. The test compares the blood pressure at your ankle and arm both at rest and after light exercise. The blood pressure readings can help clarify whether blood flow is reduced, which may indicate PVD. You may also have tests that provide more detail on the condition of the arteries. They may include one or more of the following:

• Doppler ultrasound
• Angiograph
• Magnetic resonance angiography (MRA)

If you are diagnosed with PVD, you should also be screened for other atherosclerosis related diseases. Blood vessels that supply the heart and brain are especially important to monitor for narrowing or blockage because of the risk of coronary artery disease, heart attack, or stroke.

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