Peripheral Vascular Disease
Peripheral vascular disease affects the arteries and veins that
circulate blood throughout the body and may include the narrowing
or blockage of these blood vessels, blood clot formation within
them, or an inflammatory process. Impairment or blockages within
the
arterial circulation and the venous circulatory system result in
a variety of painful and sometimes life-threatening situations.
Peripheral Arterial Disease or Arterial Blockage
Arterial blockages that occur in the peripheral circulation can
be the result of plaque accumulation. As in coronary artery disease,
lack of adequate blood supply may occur in the presence of such
blockages, and tissue ischemia my result. Ischemia refers to insufficient
amounts of oxygen-enriched blood reaching the involved area.
When ischemia occurs, pain results in the area affected by the
lack of blood supply. In the peripheral arterial circulation, this
pain can occur in the legs, thighs, or feet, and its intensity
may reflect the severity of the blockage causing it. When an arterial
blockage occurs in the lower extremities, the area affected may
develop diminished pulses, become cold to the touch, and have a
blue-tinged discoloration.
Calf or buttock pain with activity is a possible indicator of
arterial blockage. The cramping and discomfort are related to the
inadequate amounts of oxygen being delivered to the surrounding
muscle and tissues. This interruption of blood flow is referred
to as intermittent claudication. By reducing the activity level
and the increased demand for oxygen created by exercise, the pain
will subside.
Acute cramping that occurs with vigorous exercise and at night
should not be confused with claudication. Experiencing a so-called “charlie
horse” is due to muscle spasms and
not arterial disease.
Ultrasound imaging may be ordered to assess the blood flow through
the peripheral arteries. Using sound waves, images of the flow
are reproduced and areas of blockage can be identified. Arteriography,
in which dye is injected via a major blood vessel and
x-ray pictures are taken of the blood circulation, is another option
for assessment of arterial blockages.
Lifestyle modification may be recommended as part of a treatment
plan for arterial blockages. This might include effective management
of high blood pressure, elevated cholesterol, and diabetes. Patients
would be advised to stop smoking. A physician-directed exercise
plan may be encouraged.
Procedural intervention to address arterial blockages may be undertaken
where appropriate. Balloon angioplasty and stent placement, in
which a balloon catheter is used to disrupt the plaque accumulation
at the blockage site, may be recommended. The placement of a stent,
or a wire mesh tube, may occur in an attempt to prevent reblockage
at the angioplasty site.
Surgically, a peripheral vascular bypass, is another possibility
for the alleviation of an arterial blockage. In this surgical intervention,
an artificial vessel or one of your own can be utilized to construct
a bypass route that allows blood to flow around an existing blockage.
