Non-Surgical Treatment Options to Improve Your Lifestyle...Or Save Your Life

Peripheral vascular disease (PVD), also known as peripheral arterial disease (PAD), develops most commonly as a result of atherosclerosis, or "hardening of the arteries." This occurs when cholesterol and scar tissue build up, forming a substance called plaque inside the arteries which become narrowed and clogged. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking, and in some cases gangrene and amputation.

People with PVD are at increased risk for heart disease, aortic aneurysms and stroke. PVD is also a marker for diabetes, hypertension and other conditions.

Symptoms of PVD
The most common symptom of PVD is claudication, which is leg pain that occurs when walking or exercising and disappears when the person stops the activity. Other symptoms include: numbness and tingling in the lower legs and feet, coldness in the lower legs or feet and ulcers or sores on the legs or feet that don't heal.

How is PVD Diagnosed?
The most common test for PVD is the ankle-brachial index (ABI), a painless exam in which a special stethoscope is used to compare the blood pressure in the patient's ankles and arms. Based on the results of the ABI, as well as the individual's symptoms and risk factors for PVD, a physician can decide if further tests are needed. When the ABI indicates that an individual may have PVD, other imaging techniques may be used to confirm the diagnosis, including duplex ultrasound, magnetic resonance angiography (MRA) and computed tomography (CT) angiography.

Risk Factors Associated with PVD?
There are several risk factors associated with PVD including:

• Smoking
• High blood pressure (hypertension)
• High cholesterol
• Diabetes
• Family history of heart or vascular disease
• Being overweight
• Lack of exercise or physical activity
• Age over 50

What are The Treatments for PVD?
In some cases, lifestyle changes including smoking cessation, a structured exercise program and a low-fat diet can stop the progress of PVD and manage the disease. Sometimes, medications including those that lower cholesterol or control high blood pressure are prescribed to treat PVD. For other individuals, procedures that open up clogged blood vessels are necessary to treat PVD.

Major surgery is sometimes required to remove blockages from arteries or to bypass the clogged area. These procedures are performed by vascular surgeons. In many cases, however, interventional radiologists can open blocked or narrowed blood vessels caused by PVD and other conditions without major surgery using one of the following techniques:

• Angioplasty: In this technique, the interventional radiologist inserts a very small balloon attached to a thin catheter into a blood vessel through a small nick in the skin. The catheter is threaded under x-ray guidance to the site of the blocked artery. The balloon is then inflated to open the artery.

• Stenting: This procedure allows the interventional radiologist to insert a small metal tube called a stent to hold the blood vessel open.

• Thrombolytic Therapy: If the blocked artery is caused by a blood clot, thrombolytic drugs which dissolve clots are injected through a catheter to eliminate the clot and restore blood flow.

Benefits
For most cases with these minimally-invasive procedures hospitalization and general anesthesia are usually not required, there is no surgical incision--just a small nick in the skin, no stitches are needed and patients may return to normal activity shortly after the procedure.

For more information or to schedule an appointment with a Paoli Hospital interventional radiologist,
Call 610-648-1255.