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Health Condition

Peripheral Vascular Disease

About This Condition

Peripheral vascular disease (PVD) refers to a variety of conditions that primarily affect the arteries of the body, with the exception of the coronary arteries that supply blood to the heart. (Those are covered in the article on cardiovascular disease.) The most common areas for PVD are the arteries of the legs and upper arms, the carotid (neck) arteries, the abdominal aorta and its branches, and the renal (kidney) arteries. 

The cause of most types of PVD is hardening of the arteries (atherosclerosis), which itself has many causes. Conditions affecting the veins, such as chronic venous insufficiency, varicose veins, and hemorrhoids, are not usually included in PVD.  

PVD of the carotid arteries is a major cause of stroke. Intermittent claudication refers to pain in the lower legs after walking short distances and is caused by PVD of the leg arteries. One cause of erectile dysfunction may be PVD of the penis. Raynaud’s disease is a painful condition caused by spasms of arteries after exposure to cold. Thromboangiitis obliterans (TAO), also known as Buerger’s disease, is an uncommon PVD that occurs in both arteries and veins. This condition causes tender areas of inflammation in the arms or legs, followed by cold hands or feet.

Aneurysm is a ballooning of an artery due to weakening of the blood vessel walls. Aneurysms may be an inherited disorder or may be due to atherosclerosis.1,2 The most common aneurysm is abdominal aortic aneurysm (AAA), which occurs in the large artery that carries blood from the heart to the lower body. AAA is much more common in men, and risk increases with age. Large AAAs are usually surgically repaired because they can undergo life-threatening ruptures.

Symptoms

People with peripheral vascular disease may have symptoms of pain, aching, cramping, or fatigue of the muscles in the affected leg that are relieved by rest and worsened by elevation. Other people with peripheral vascular disease may have swollen feet and ankles accompanied by a dull ache made worse with prolonged standing and relieved by elevation. People with chronic peripheral vascular disease may have darkened areas of skin, leg ulcers, and varicose veins.

Other Therapies

Exercise rehabilitation therapy, weight loss, and smoking cessation is often recommended. Healthcare providers might advise individuals to elevate their legs frequently, avoid prolonged standing or sitting, and wear graduated compression stockings with supportive shoes. Surgical options to restore blood supply (revascularization procedures, such as, angioplasty, atherectomy, stent placement, and bypass) are usually reserved for those with progressive or disabling symptoms. Any ulcers that develop are treated with compressive bandages that contain antibiotic solutions. Recurrent ulceration may be surgically treated with skin grafts and repair or bypass of the affected veins.

References

1. Anderson LA. An update on the cause of abdominal aortic aneurysms. J Vasc Nurs 1994;12:95-100 [review].

2. MacSweeney ST, Powell JT, Greenhalgh RM. Pathogenesis of abdominal aortic aneurysm. Br J Surg 1994;81:935-41 [review].

3. Mishima Y, Kamiya K, Sakaguchi S, et al. A multiclinic double-blind trial of pyridinolcarbamate and inositol niacinate in ischemic ulcer due to chronic arterial occlusion. Angiology 1977;28:84-94.

4. Stammler F, Diehm C, Hsu E, et al. The prevalence of hyperhomocysteinemia in thromboangiitis obliterans. Does homocysteine play a role pathogenetically? Dtsch Med Wochenschr 1996;121:1417-23 [in German].

5. Olszewer E, Carter JP. EDTA chelation therapy in chronic degenerative disease. Med Hypotheses 1988;27:41-9.

6. Chappell LT, Janson M. EDTA chelation therapy in the treatment of vascular disease. J Cardiovasc Nurs 1996;10:78-86.

7. Olszewer E, Sabbag FC, Carter JP. A pilot double-blind study of sodium-magnesium EDTA in peripheral vascular disease. J Natl Med Assoc 1990;82:173-7.

8. Guldager B, Jelnes R, Jorgensen SJ, et al. EDTA treatment of intermittent claudication—a double-blind, placebo-controlled study. J Intern Med 1992;231:261-7.

9. Van Rij AM, Solomon C, Packer SGK, Hopkins WG. Chelation therapy for intermittent claudication. A double-blind, randomized, controlled trial. Circulation 1994;90:1194-9.

10. Zheng P. Traditional Chinese medicine anesthesia in severe thromboangiitis obliterans. Report of 30 cases. Chin Med J (Engl) 1988;101(3):221-4.

11. Yang BH, Zhang SG. Study of thromboangiitis obliterans treated with “vascular no. 3” using Doppler ultrasound. Chung Hsi I Chieh Ho Tsa Chih 1989;9:596-8, 581 [in Chinese].

12. Szuba A, Cooke JP. Thromboangiitis obliterans. An update on Buerger's disease. West J Med 1998;168:255-60 [review].

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.