Peripheral Vascular Disease

Blood flows from our heart to various parts of our body via blood vessels called arteries. Similarly, the vessels which transport blood back to heart are called veins. Peripheral Vascular Disease is a blood circulation disorder in which blood flow outside of our heart via blood vessels is reduced or blocked. Such blockage can happen both with arteries or veins however since mostly the same is observed in arteries, PVD is also referred to as Peripheral Arterial Disease (PAD). PVD is the most common disease of the arteries.

The blockage of arteries happens due to Arteriosclerosis i.e. hardening of arteries due to plaque formation in the arteries or blockage can also happen due to blood vessel spasms. In Arteriosclerosis, the plaque growth slowly inside the arteries increases and may ultimately completely block the artery resulting in organ damage, if left untreated.

While PVD is mostly observed in legs, it may also develop in blood vessels supplying blood to your other body parts like arms, kidneys etc.

PVD is characterised by narrowing of blood vessels thus obstructing free flow of blood in the body. This mainly happens due to

• Atherosclerosis i.e. build-up of plaque in the blood vessels. Plaque builds up on artery walls reducing the space for blood to flow effectively. It is the most common cause of PVD. Development of plaque in human body happens due to various factors as highlighted below in the ‘Who is at risk section’.
• Any accidental injury or irregular muscle anatomy
• Any Infection

Yes, Peripheral Vascular Disease or Peripheral Arterial Disease is a serious health condition which should not be left unattended. PVD is a leading cause of disability among people over age 60, as well as those with diabetes. However it should not be assumed that it is only age related problem as PVD develops and grows slowly in the body and hence an early treatment will avoid any complication in old age.

If PVD is not treated in time it may lead to following:

• Amputation of Limb: As PVD advances there comes a stage where blood flow to the limbs is fully blocked thus supply of fresh blood and tissue is stopped. The tissues start decaying due to lack of oxygen and results into development of Gangrene leading to amputation of limb.
• Extremely Painful and Non Healing Ulcers: Fresh blood flow is required by body to heal any injury and maintaining health. Once blood flow is blocked, any injury in that part of the body is difficult to heal. Also due to non supply of blood, chances of development of infection is high. In advance cases such ulcers and injuries may lead to amputation or death.
• Diabetic Foot Ulcers are commonly seen developed due to PVD and if untreated the same definitely leads to amputation of limb.
• Extreme Pain in the effected body part
• Restricted Mobility due to loss of muscle strength in the effected body part
• Stroke: People suffering PVDs are three times more likely to get Stroke.

While PVD is an extremely dangerous health condition, with aggressive treatment under expert doctor it may be treated and above complications be avoided.

Early Diagnosis is key to treatment. While the early symptoms of PVD are generic, the good part is that there are various tests which can be performed to identify the complication.

• Ankle-brachial index (ABI): An inexpensive test which can be a very good indicator of existence of PVD. It is highly recommended that you get this very inexpensive test included in your annual health check. If you do face any symptoms it is recommended that you consult your doctor or visit an Interventional Radiologist for this test. An ABI is a comparison of the blood pressure in the ankle with pressure in the arm using a regular blood pressure cuff and a Doppler ultrasound device.
• Doppler Ultrasound: High-frequency sound waves and a computer is used to create images of blood vessels, organs & tissues. Doppler technique is used to measure and assess the flow of blood. Faintness or absence of sound may indicate an obstruction in the blood flow.
• Magnetic resonance angiography (MRA): This non-invasive diagnostic procedure uses a combination of a large magnet, radio frequencies, and a computer to produce detailed images of organs and structures within the body. An MRA is often used to examine the brain and other soft tissues and to assess blood flow.
• Angiogram: This is an X-ray of the arteries and veins to detect blockage or narrowing of the vessels. This procedure involves inserting a thin, flexible tube into an artery in the leg and injecting a contrast dye. The contrast dye makes the arteries and veins visible on the X-ray.

The above are primarily used to diagnose PVDs. Ankle-Brachial Index is very inexpensive test and should be adopted earlier before getting other tests done.