PERIPHERAL VASCULAR DISEASE

WHAT IS IT?

Peripheral vascular disease is narrowing of blood vessels supplying the blood flow to the limbs. The narrowing is because of hardening of arteries caused by cholesterol deposits within the arterial wall.

WHAT ARE THE SYMPTOMS?

In the initial stages, the disease is not symptomatic. One of the first sign of peripheral vascular disease is difficulty in walking called intermittent claudication. Patients complain of pain in leg on walking with relief from pain on stopping. As the disease progresses, the pain becomes constant even at rest. This further leads to ulcers or gangrene in the legs which is potentially life threatening besides requiring amputation of the affected part.

WHO IS AT RISK?

Patients with known heart disease and stroke are at high risk of getting peripheral vascular disease as the underlying disease pathology is similar. One of the groups of patients at particular risk in our local population is patients with diabetes. Other risk factors include smoking, hypertension, hyperlipidemia, and patients with renal failure.

HOW DO WE DIAGNOSE PVD?

In the early stages, one of the screening tests is a simple non-invasive test called Ankle Brachial Index (ABI) measurement. This involves measuring blood pressure in the arm and leg simultaneously. With advanced disease, other non-invasive tests like ultrasound, CT or MRI scan can be done.

HOW DO WE TREAT PVD?

One of the first things done in patients with PVD is to control their risk factors well with proper medical management such as controlling diabetes, hypertension, high cholesterol etc.

For significant symptoms, further management options are open surgery or minimally invasive endovascular treatment which is angioplasty and stent placement. Minimally invasive methods of treatment such as angioplasty are now becoming extremely popular as they are as effective as surgery with shorter recovery times. For a significant number of patients, this can be done as a day procedure with discharge from the hospital on the same day.