Peripheral vascular disease, also known as peripheral arterial disease, refers to a range of symptoms that occur due to the narrowing of the arteries other than those that supply the heart or the brain. When narrowing occurs in the heart it is called coronary artery disease while in the brain it is called cerebrovascular disease.
Peripheral artery disease most commonly affects the legs, but other arteries may also be involved. The affected blood vessels continue to narrow over months and years, and at some point the arteries become completely blocked.
A. SIGNS AND SYMPTOMS:
Other symptoms such as skin ulcers, bluish skin, cold skin, or poor nail and hair growth may occur in the affected leg.
Complications may include an infection or tissue death which may require amputation; coronary artery disease, or stroke.
Up to 50% of cases are without symptoms.
B. RISK FACTORS:
Increased blood lipids (fats and cholesterol)
Lack of physical exercise
Hypertension (high blood pressure)
C.Peripheral Angiography and Angioplasty TREATMENT:
There are three lines of treatment, based on the severity of the disease
Management of hypertension.
Regular exercise for those with claudication helps open up alternative small vessels (collateral flow) and the limitation in walking often improves.
Management of high cholesterol with a low-fat diet
Antiplatelet drugs to prevent blood clots
45yrs male, heavy smoker and known diabetic for 7yrs had complains of severe leg cramps(Claudication) on walking for 100m. Angiography showed severe calcific stenotic occlusion at the left common iliac artery origin with a pressure gradient of >40mmHg. Also noted a plaque at the right common iliac artery causing 50-60% narrowing.
Bilateral common Iliac artery balloon mounted stent deployment done.
Post deployment, the left Iliac artery pressure gradient normalised.
62yrs female, with uncontrolled diabetes and also has hypertension on regular medication came with a non healing wound involving the left great toe. On examination, no peripheral pulses felt.
Angiography showed diffuse atherosclerotic changes involving the left leg arteries with a focal 3-4 cm severe calcific stenotic occlusion at the mid Superficial Femoral artery with sluggish flow in the leg.
Left superficial Femoral artery was stented and balloon angioplasty done.
Post angioplasty, all the peripheral pulses were felt. The wound healed in one month.