What is peripheral vascular disease?
Peripheral blood vessels are all of the blood vessels outside of the heart. Peripheral vascular disease develops when these blood vessels become blocked with cholesterol plaque. Peripheral vascular disease can affect the arteries that carry blood to the legs, arms, kidney, and brain. Peripheral vascular disease (PVD) is also called peripheral arterial disease (PAD).

Why is peripheral vascular disease important?
Peripheral vascular disease frequently coexists with coronary artery disease, which can increase the risk of heart attack. Blockages in the carotid arteries can increase the risk of stroke. Blockages in the kidney artery can cause uncontrolled blood pressure and increase the risk of kidney failure.

What are the symptoms of peripheral vascular disease?
The symptoms vary depending on the location of the plaque buildup. Patients with peripheral vascular disease of the legs may have dull cramping pain in the hip, thighs, or calf muscles (called claudication). Other symptoms include numbness or tingling in the feet, changes in skin color or temperature, impotence or erectile dysfunction, and infection or sores that do not heal.

What are the risk factors for peripheral vascular disease?

• Age
• Family history of heart or vascular disease
• Smoking
• High blood pressure
• High cholesterol
• Diabetes

What types of tests are available for peripheral vascular disease?

• Ankle Brachial Index (ABI)
• Doppler ultrasound
• Angiogram
• MRI

What is the Ankle Brachial Index (ABI)?
An Ankle Brachial Index or ABI is a screening test for peripheral vascular disease of the lower extremities. The nurse will check the blood pressure in both legs and in the arm. Normally the blood pressure in the legs is equal to or slightly higher than the arm. If there is plaque buildup in the arteries of the legs, the blood pressure in the affected leg will be lower. If this screening test is abnormal, your doctor may recommend more detailed testing.

What is a Doppler ultrasound?
A Doppler ultrasound uses sound waves to image the heart and blood vessels. Doppler ultrasound is used to assess the carotid arteries in the neck for plaque buildup. Plaque in the carotids can increase the risk of stroke. Doppler ultrasound can also be used to assess the heart function – this specialized test is also called an echocardiogram. Sometimes ultrasound is used to assess the size of the abdominal aorta for enlargement (aneurysm).

What is an MRI?
An MRI (magnetic resonance imaging) uses magnetic waves to create an image of the blood vessels. During the MRI test, patients lie on a table in a large tube. An intravenous line is placed in the arm, and the technician will place contrast die into the iv. Before entering the MRI room, patients should remove all jewelry, hearing aids, and anything with metal. Patients with pacemakers, defibrillators, and other metal implants should not undergo MRI. The magnets in the MRI machine are very strong.

What is an angiogram?
If a blockage is suspected, an angiogram may be recommended. An angiogram allows your doctor to directly visualize the peripheral arteries. A small, flexible tube called a catheter is inserted through a blood vessel in the groin. Your doctor gently steers the catheter toward the blocked blood vessel. Dye put in through the catheter allows your blood vessels to show up as images on a monitor. Blockages in the arteries can be seen at this time. Your doctor will take pictures from many different angles. Patients receive medication to relax during the procedure to minimize any discomfort.

If a blockage is seen in one of the arteries, an angioplasty procedure may be performed to open the blockage and restore blood flow. During an angioplasty, a special catheter with a balloon tip is placed near the area of blockage. The balloon is inflated and presses the plaque against the vessel wall. Sometimes a stent may be placed as well. A stent is a tiny mesh tube that holds the artery open. Stents also prevent arteries from becoming blocked again.