Peripheral Arterial Disease(PAD)/Peripheral Vascular Diseases (PVD)

Peripheral Vascular Disease (PVD) is a circulation disorder that affect blood vessels outside the heart and brain. PVD that develops only in the arteries is called Peripheral Arterial Disease (PAD). PAD develops most commonly as a result of atherosclerosis, or hardening of the arteries, which occurs when cholesterol and scar tissue build up, forming a substance called plaque inside the arteries. This is a very serious condition. The clogged arteries cause decreased blood flow to the arms, or more commonly, the legs. This can result in pain when walking and eventually gangrene and/or amputation.

Signs and Symptoms:
The most common symptom of PAD is called intermittent claudication, which is painful cramping in the leg or hip that occurs when walking or exercising and typically disappears when the person stops the activity. Other symptoms include: numbness, tingling and weakness in the lower legs and feet, burning or aching pain in feet or toes when resting, sore on leg or foot that won’t heal, cold legs or feet, color changes in skin of legs or feet, hair loss on legs, pain in the legs or feet that wakes you up at night.

PVD that develops in the deep veins in the body is usually caused from claudication and is called Deep Vein Thrombosis (DVT).

In order to diagnose PVD, the physician will begin by taking a complete medical history and physical exam. Several tests may be used to diagnose PVD. They are:

  • Measuring the pulses in your legs and feet
  • Doppler ultrasound
  • Ankle-Brachial Index (ABI)
  • Pulse Volume Recording (PVR)
  • Angiography

Arterial Duplex Ultrasound Scan
An Arterial Duplex Ultrasound is a non-invasive imaging scan that uses sound waves to create a color map of the arteries in your leg(s) to identify narrowing of your vessels that may be causing leg pain when walking or at rest, ulcers of the foot, ankle, heel or toe(s),  or skin discoloration.

Peripheral Angiograms:

Abdominal aortograms with runoff are arteriograms of the lower abdominal aorta and arteries in the legs. This exam is often done when the patient has pain in the calf muscle after walking a short distance, discoloration of the toes or feet, non-healing wounds or ulcers, or a “cold” foot.

Treatment Options:
Once angiographic images have been obtained and problem areas identified, some of the methods we utilize to treat those diseased areas are Angioplasty, Thrombectomy, Atherectomy, or Stent placement.

Angioplasty uses a balloon catheter to open up a stenotic area (or area of narrowing) in a blood vessel.

Thrombectomy is a process in which thrombus (or clot) is mechanically removed from the body using specialized equipment.

Athrectomy refers to the mechanical removal of atheroma or atherosclerosis from the inside of the vessels in the body, using specialized catheters and equipment.

Stents are small metal scaffolds that can be placed in order to maximize the inner diameter of vessels and help to keep it open.