Treatment Options for Peripheral Vascular Disease (PVD)

What is peripheral vascular disease?

Peripheral vascular disease (PVD) is a progressive circulatory condition that involves the narrowing, blockage, or spasms of blood vessels located outside the heart. It is sometimes referred to as peripheral artery disease (PAD); however, peripheral artery disease is a specific type of peripheral vascular disease that only affects the arteries. Peripheral vascular disease is an umbrella term for circulatory conditions that affect the arteries, veins, or lymphatic vessels. Because PVD involves the narrowing, blockage, or spasms of blood vessels, blood flow is restricted in the affected vessel which reduces the transport of oxygen and nutrients to specific areas of the body. The affected area of the body depends on the location of the narrowed or blocked vessel(s); however, PVD most commonly affects the limbs, especially the legs.

Treatment options

Depending on the severity of PVD, treatment includes changes in lifestyle, medications, or surgery to treat symptoms, stop the progression of the condition, and decrease the risk of heart attack or stroke.

Lifestyle changes

Various lifestyle modifications may keep peripheral vascular disease from progressing:

• Maintaining a healthy diet helps lower high cholesterol as well as lipid levels. A healthy diet also helps lower blood pressure. Both high cholesterol and high blood pressure are contributing factors in the progression of peripheral vascular disease.
• Engaging in regular exercise increases circulation and helps condition the muscles so that oxygen supplied from the blood can be effectively used.
• Quitting the habit of smoking eliminates a primary risk factor of the progression of the PVD. It also lowers the risk of amputation (a complication of severe PVD).
• Obtaining treatment of medical conditions that contribute to PVD, such as high blood pressure, high cholesterol, and diabetes, helps prevent progression of PVD.

If help is needed with lifestyle modifications, meeting with a behavioral psychologist or nutritionist is beneficial.

Medications

Changes in the lifestyle are sufficient for some cases of PVD. However, others require medication, such as antiplatelet agents (blood thinners) or medications to relax the blood vessel walls, to help increase blood flow. Medications for lowering cholesterol and increasing blood supply to the extremities may also be prescribed.

Surgery

If peripheral vascular disease is severe and blood flow in a blood vessel is blocked or severely restricted, surgery may be required. The various surgical procedures used to treat PVD include the following:

• Angioplasty — A catheter (long, hollow tube) is inserted into the affected blood vessel, increasing blood flow. Various types of angioplasty procedures can be performed to create a larger opening in the affected vessel, including balloon angioplasty (balloon is temporarily inflated inside the vessel), atherectomy (blockage is shaved), laser angioplasty (blockage is vaporized by a laser), and a stent procedure (small coil is permanently placed in the vessel).
• Vascular surgery — A new pathway for blood flow is created, bypassing the affected vessel (using a blood vessel from another part of the body or a tube made of synthetic material).