Peripheral Vascular Disease/Peripheral Artery Disease (PVD/PAD)
What is peripheral vascular disease or peripheral artery disease?
Just 20 percent of the 10 million Americans affected by peripheral vascular disease (PVD), also called peripheral artery disease (PAD), is diagnosed, largely because the condition is often overlooked as something you have to live with or as a sign of aging. PVD is a serious condition that slowly restricts blood flow to the legs and other areas of the body when the arteries become clogged.
The most common sign of PVD is claudication or leg pain while walking or exercising, which stops when the activity stops. Many people don't recognize this pain as a sign of a potentially serious condition.
In addition to symptoms such as dizziness, blurred vision and difficulty walking due to poor blood flow, serious complications can result from PVD, such as:
- Uncontrolled high blood pressure due to blocked arteries to the kidneys
- Increased risk of stroke due to narrow carotid arteries to the brain
- Amputation of the leg due to lack of blood reaching leg muscles
Most people associate atherosclerosis with clogged arteries to the heart, but the disease can have wider-reaching effects and cause a variety of problems. Fortunately, Lankenau Heart Institute interventional cardiologists can offer, in most cases, minimally invasive treatments to relieve the blockages.
PVD treatment options
If you are experiencing leg pain, a simple test called the ankle brachial index (ABI) can detect whether you have PVD. Your physician measures the blood pressure in your arm and in your ankle and compares the ratio, which should be about the same or slightly higher in the ankle. If necessary, other noninvasive tests, such as an ultrasound of the legs, a CT scan, or MRI angiography—may be used to confirm the diagnosis.
Treating PVD begins with treating the underlying atherosclerosis. Making certain lifestyle changes, such as adjusting your diet, increasing your physical activity, and quitting smoking—along with medication, if necessary—can lower cholesterol levels, decrease blood pressure, and control diabetes—all of which are factors in the progression of 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 cardiologists can open blocked or narrowed blood vessels without major surgery using the latest nonsurgical, outpatient procedures.
- Angioplasty – In this technique, the physician threads a balloon-tipped catheter into the blocked artery and inflates the balloon to open the clogged vessel and allow the blood to flow where it is needed.
- Stenting – The insertion of a stent in the affected artery, usually occurs with angioplasty to keep the blood vessel propped open and to prevent it from re-narrowing.
For patients with calcified PAD, in which plaque buildup in the arteries has become hardened with calcium, Bryn Mawr Hospital, part of Lankenau Hart Institute is the first hospital in the Philadelphia region to introduce the Shockwave Medical Lithoplasty System, the first and only technology that uses sound waves to break up calcification and effectively treat patients with this difficult-to-treat condition.
Taken together, these minimally invasive procedures for PVD provide patients with effective treatments that can be performed with local anesthesia under imaging guidance, are faster than surgery, and avoid surgical complications.
Treatments
Lithoplasty
Until the use of lithoplasty, it has been difficult to treat people who have calcified PAD with standard treatments such as balloon angioplasty and stenting.
Percutaneous Transluminal Coronary Angioplasty (and Stenting)
Coronary angioplasty is a treatment for atherosclerosis, which you may need if diet and lifestyle changes aren’t enough to improve blood circulation to the heart. Learn more about what to expect during angioplasty and stenting procedure.