Peripheral Vascular Disease (PVD)
Affecting approximately 1.5-2 million people in the United States,
peripheral vascular disease ( PVD) is a circulatory disorder characterized by narrowing of the blood
vessels, usually in the legs. Twenty percent of adults over 70 have PVD
This condition is typically caused by arteriosclerosis, a buildup of plaque
(fatty substances along the inner wall of the arteries), the same process
that causes blockages in the arteries of the heart. Peripheral arterial
disease is associated with an increased risk of heart attack.
Risk factors for PVD include:
- Smoking - smokers have a 3-fold increased risk for PVD
- High cholesterol
- High blood pressure
- Age (usually 50 and older)
- Those with a history of heart, carotid disease, or stroke
- A sedentary lifestyle (physical activity)
Symptoms of PVD vary, depending on the affected area, but may include:
- Claudication - cramping or fatigue in the legs while walking, which disappears
after a few minutes of rest.
- Pain in the feet while in bed
- Slow healing or non-healing sores on the feet or legs
- Numbness, tingling, or coldness in the lower legs or feet
The first step in diagnosing PVD is thorough history and physical examination
by your physician, including an examination of pulses and any sores on
the legs or feet.
Non-Invasive Testing at Anaheim Regional includes:
Ankle brachial index:
Uses blood pressure cuffs and a handheld doppler device to determine the
blood pressure at the ankle and in the arms. If the blood pressure in the
lower part of your leg is lower than the pressure in your arm, you may have PVD
- A noninvasive ultrasound test to look for areas of narrowing or blockage
in the arteries of the legs and pelvis
- A state of the art CT scanner is used to determine if there are areas of
narrowing or blockage in the arteries. This test involves x-rays and the
injection of dye into the veins, which is used to visualize the arteries.
Arteries throughout the body can be examined using this test.
Digital subtraction angiography (DSA)
- DSA is the "gold standard" to diagnose, and often to treat vascular
disease. It involves getting detailed x-ray images of the arteries while
injecting dye directly into the arteries. For patients with poor kidney
function, a non-toxic gas carbon dioxide can be used in place of IV dye.
Blockages can often be opened minimally invasively during an angiogram.
- Medical: Most people who have cramping or pain with walking can be treated
medically to relieve symptoms and reduce the risk of heart attack by measures
such as smoking cessation, exercise, and drug therapy
Interventional: People who have cramping or pain that significantly affects
their daily life, or those with non-healing sores or gangrene may require
intervention. The goal of intervention is to relieve symptoms, allow for
healing, and reduce the risk of amputation by improving blood flow. The
Advanced Endovascular Institute seeks to achieve optimal outcomes using
minimally invasive techniques involving lower risks, minimal discomfort,
and shorter hospitalizations than traditional open surgical approaches.
Minimally invasive angioplasty and stenting can usually be done as an
outpatient or with a short hospitalization. It is less invasive and less
painful than open surgery. However, it may also be less durable than open surgery
Surgical bypass involves using vein or artificial conduit to "bypass"
blood flow around areas of blockage and restore more normal circulation.
It is significantly more invasive than angioplasty and stenting, requiring
a longer hospital stay and recovery period, but may be more durable over
the long term.
The specialists of the Endovascular Institute are trained in both angioplasty
techniques as well as open surgery, and customize treatment to each patient.