Vascular and Endovascular Diagnosis & Treatment

Peripheral vascular disease (PVD), also called peripheral artery disease (PAD), is a narrowing of the arteries in your limbs, most often in the legs. The condition is usually caused by deposits of a fatty substance called plaque, and it can be a sign of blockages in other parts of your body, such as your arms. More uncommon causes can be blood vessel inflammation, irregularities in muscle or ligament anatomy, injury and exposure to radiation.

Peripheral vascular disease symptoms

Many people don’t experience any symptoms of PVD; those who do may have one or more of the following symptoms:

  • Leg pain, aching, numbness and/or heaviness after activity
  • Weak or absent pulse
  • Paleness or a bluish tint to the skin
  • Cold skin, compared to your other arm or leg
  • Poor nail and hair growth
  • Sores and/or wounds that heal slowly or not at all
  • Erectile dysfunction in men

Diagnosing peripheral vascular disease

Your physician will ask you about symptoms you may be experiencing and may listen for a weak pulse in the arteries in your arms and legs. To confirm a diagnosis of PVD, your physician may order one or several of the following procedures:

Ankle-brachial index (ABI)

This simple, noninvasive procedure compares the ratio of blood pressure in the arms and legs. An abnormal ratio between the two may indicate decreased circulation in blood vessels.

Ultrasound

An ultrasound procedure uses sound waves to produce images of blood flowing through arteries.

64-Slice CT angiography

During this noninvasive test, a CT scanner (a type of X-ray machine) rotates around the body taking a series of images. These images are then reconstructed on a computer and provide detailed pictures of arteries and other body structures.

Arteriography

During this procedure, a contrast dye is injected into a blood vessel, which allows physicians to see areas of blockage on a monitor. This procedure may be used in conjunction with endovascular treatment (balloon angioplasty and stent placement).

Treating peripheral vascular disease

Treatment can help you manage symptoms of PVD. Depending on your situation, your provider may prescribe medicine to lower your blood pressure or cholesterol, control blood sugar and prevent blood clots.

Lifestyle modifications

If a blockage is not severe, it may be controlled with lifestyle modifications that include losing weight, exercising and stopping smoking. Learn more about cardiovascular wellness and support.

In some cases, surgery may be the best option to help prevent complications, such as heart attack or stroke. Our surgeons and interventional cardiologists are dedicated to providing you with high-quality care to treat your PVD. Surgical and endovascular treatments can include:

Angioplasty and stenting

A catheter will be guided to where plaque is blocking your blood vessel. When it’s in place, a small balloon will inflate that pushes the plaque against the vessel’s interior walls. A stent (a small mesh tube) can then be inserted to support the veins or arteries and restore blood flow.

Atherectomy

Using a catheter with a small cutting device attached, your provider will cut out or shave off plaque buildup in your blood vessels. Large pieces of plaque will be removed from your body through the catheter. In some cases, a laser may be used to dissolve the plaque.

Endarterectomy

This surgery is often used to remove blockage from the carotid arteries on either side of the neck. For this surgery, you will first have a local or general anesthetic. After a small incision is made in the neck, the artery will be opened and the blockage cleaned out. Your surgeon may decide to insert a graft (part of a vein or a man-made material) to help keep the artery open. The artery is then sewn shut.

Peripheral vascular bypass

Your physician may recommend that you have surgery to bypass a blocked blood vessel. This procedure involves taking a vein from another part of your body to be used as a bypass graft. An incision is then made in your arm or leg to access the blocked blood vessel. The graft is sewn above and below the blockage, allowing blood to bypass the obstruction. 

Are you at risk for peripheral vascular disease?

There are risk factors that you can control as well as risk factors you cannot control.

Risk factors you can control include:

  • Smoking
  • Being overweight
  • An inactive lifestyle
  • High LDL levels
  • Low HDL levels
  • High triglyceride levels
  • High blood pressure
  • Diabetes
  • Stress

Risk factors you cannot control include:

  • Your age. You are at risk of a heart attack or stroke if you are male and older than 45. If you are female, your risk increases after age 55.
  • Your gender. More men have heart attacks earlier in life, but more women than men die from cardiovascular disease.
  • Your family history. A family history of cardiovascular disease puts you at risk of developing the disease.