What is Peripheral Vascular Disease (PVD)?

Often referred to as "poor circulation" Peripheral Vascular Disease (PVD) is a blood circulation disorder that limits the supply of blood to the extremities as a result of narrowing and blockages of arteries.

PVD develops due to a build-up of plaque inside artery walls (atherosclerosis.) Plaque reduces blood flow to the legs and sometimes arms, preventing enough oxygen and nutrients from getting to the muscles and other tissues (primarily your feet.)

What are some of the causes of PVD?

Inflammation, plaque buildup and tissue damage are among the top causes for PVD. These causes are often brought about by smoking, diabetes, high cholesterol and heredity. Extreme injuries to muscles or ligaments and infections can also cause this disease in rare cases.
Risk factors Include:

  • Smoking and other tobacco use
  • Diabetes (uncontrolled high blood sugar)
  • Obesity (a body mass index over 30)
  • High blood pressure
  • High cholesterol
  • Increasing age, especially after reaching 50 years of age
  • A family history of peripheral vascular disease

What are the symptoms of PVD?

The early symptoms of PVD can often mimic symptoms more commonly associated with back pain and arthritic conditions. The most common symptom of PVD is claudication (reproducible pain in the legs with exercise.) Pain and muscle cramping in the legs might be felt when walking long distances early on. Over time the pain can worsen and patients can only walk short distances without resting due to pain and muscle cramping.
As the disease becomes more severe, patients may begin to feel foot pain at rest. Most notably, patients are awakened in the night with pain and muscle cramps in the feet. The pain is relieved by standing or dangling their leg over the side of the bed.

With advanced stages of PVD, some symptoms include non-healing foot ulcers, skin color changes, and gangrenous infections.

Is smoking playing a role in my PVD?

Treating patients with PVD requires addressing each risk factor that led to the development of PVD, most importantly tobacco use. We know how challenging it is to quit, but permanent abstinence from cigarette smoking is the #1 most important factor in the outcomes for those who have PVD. There are so many resources available to help you through this journey. Please talk to us about these available resources or check out this link (stop smoking document from services page).

Are there conservative treatment options for PVD?

The first thing we consider is if your PVD can be managed by making lifestyle changes like walking each day. By making different choices in your day-to-day life, you can do a lot to make sure your PVD doesn't get any worse and even avoid surgery in some cases. Some lifestyle changes we recommend include:

  • Quit smoking
  • Get more exercise (start a daily walking program)
  • Eat a healthy diet
  • Take care of your feet
  • Manage your other health problems, such as diabetes and high cholesterol

Are there outpatient surgical treatment options for PVD?

One of the first lines in the surgical management of PVD is a procedure commonly performed in an outpatient setting. An angiogram or arteriogram is a dye test performed to study the arteries in the legs. If a blockage is identified that can be re-opened with a balloon or the placement of a  stent it is often re-opened at the same time.

What to do if my Balloon treatment for PVD doesn't work?

Sometimes extensive plaques or blockages require an actual arterial bypass. The type of bypass depends upon the location of the blockage(s). A vascular surgeon will go around the blocked artery with a graft taken from the patient's own blood vessels (a vein) or a synthetic vessel to restore blood flow. These procedures are performed as an inpatient and will require a few days in the hospital for recovery.

Do patients need a physician's referral?

Approximately 90% of patients treated for PVD are physician referrals. However, patients do not need a physician referral to schedule a PVD screening at Columbia Surgical Associates. Note that some insurance policies require patients have a patient referral even for medical purposes.

If you or someone you know exhibits symptoms associated with PVD, contact Columbia Surgical Associates today to schedule a consultation with one of our board-certified vascular surgeons.

John Adams, MD
Paul Humphrey, MD
Erica Salinas, MD
Jennifer Sanford, MD