PERIPHERAL VASCULAR DISEASE

TOPICS:
1. What is Peripheral Vascular Disease (PVD)?
2. What are the Risk Factors for Peripheral Vascular Disease?
3. What are the symptoms of PVD?
4. How is PVD diagnosed?
5. What is the treatment options for PVD-related pain? 

What is Peripheral Vascular Disease?
Peripheral Vascular Disease (PVD) refers to a condition where there is restricted blood flow to the limbs, most commonly the legs, due to the narrowing or blockage of blood vessels outside of the heart and brain. This reduced blood flow can result in various symptoms, ranging from mild discomfort to severe pain and tissue damage. PVD is often caused by atherosclerosis, a buildup of plaque in the arteries, but it can also be due to blood vessel inflammation, blood clots, or other conditions affecting the vascular system.

What are the Risk Factors for Peripheral Vascular Disease?
Several factors can increase the risk of developing Peripheral Vascular Disease (PVD), including:

• Smoking
• Diabetes
• High Blood Pressure (Hypertension)
• High Cholesterol
• Advanced age
• Family History of Peripheral Vascular Disease / Ischemic Heart Disease
• Obesity

What are the symptoms of PVD?
The symptoms of Peripheral Vascular Disease (PVD) can vary depending on the severity and location of the blockage in the arteries. Common symptoms include:

• Pain or cramping in the legs, particularly during physical activity (claudication)
• Numbness or weakness in the legs
• Coldness or changes in skin color of the affected limb
• Slow-healing wounds or ulcers on the legs or feet
• Erectile dysfunction in men
• Weak or absent pulses in the legs or feet

How is PVD diagnosed
Diagnosis of Peripheral Vascular Disease (PVD) typically involves a combination of medical history, physical examination, and diagnostic tests. These may include:

• Ankle-brachial index (ABI) test - This non-invasive test compares blood pressure in the arms to blood pressure in the ankles to assess blood flow to the legs.
• Doppler ultrasound - This imaging test uses sound waves to create images of blood flow in the arteries and can help identify blockages or narrowing.
• CT angiography or MR angiography - These imaging tests provide detailed images of the blood vessels and can help identify blockages or narrowing in the arteries.
• Angiography - In this invasive procedure, contrast dye is injected into the blood vessels, and X-ray images are taken to visualize blood flow and identify blockages.

What is the treatment options for PVD-related pain? 
​Treatment for PVD-related pain usually requires a Multidisciplinary approach, involving Vascular Surgeons, Radiologists, Physiotherapists, Cardiologists and Pain Specialists. Generally, the treatments includes:

Conservative treatment

• Antiplatelet therapy to prevent clots and complications related to reduced blood flow
• Vasodilators to dilate the blood vessels and improve blood flow
• Pain relievers
• Lifestyle modification

Surgical treatment

• Angioplasty / stenting
• Bypass surgery
• Endarterectomy

If these treatments fail to work, you should see a Pain Specialist for:

• Prescription Pain Medications
• Lumbar Sympathetic Blocks - which aim to increase blood flow into the legs and reduce pain
• Spinal Cord Simulation - Interrupt nerve signals carrying pain signals into the brain.