Vascular Disease
The ability to walk without assistance is integral to quality of
life. Losing this ability as a result of peripheral vascular disease
can be devastating. Peripheral vascular disease (PVD) is a condition
in which the arteries of the legs or arms become narrow or clogged,
reducing the flow of blood. The most common symptom of PVD is pain
in one or both legs, thighs, or buttocks when walking. This is
termed claudication. Other symptoms may include numbness, tingling,
and weakness of the affected leg. In more severe cases, ulcers,
sores, or gangrene may result, ultimately leading to amputation.
Approximately 10 million people in the United States have PVD. As in
the heart arteries, PVD is caused by atherosclerosis, commonly known
as hardening of the arteries. Various factors may contribute to the
onset of PVD including cigarette smoking, high blood pressure, high
cholesterol, diabetes, obesity, and a family history of
cardiovascular disease. PVD is often seen in patients with coronary
artery disease.
Atherosclerosis may also affect the arteries to the brain
(cerebrovascular disease) and the kidneys (renovascular disease).
When blockages occur in the carotid arteries which supply blood to
the brain, there is a risk of stroke. When blockages occur in the
kidney arteries, there is a risk of a form of high blood pressure
called renovascular hypertension and kidney damage that may lead to
dialysis. When atherosclerosis affects the aorta, aneurysms may form
which can lead to tears and rupture, especially when associated with
high blood pressure.
Cardiac Specialists offers an integrated approach to the diagnosis
and treatment of vascular disease, both coronary and peripheral. The
diagnosis of PVD may be made through simple history and physical
examination, noninvasive studies (ankle-brachial index, pulse volume
recordings, ultrasound, CAT scan, MRI), or invasive studies
(angiography). The treatment of PVD focuses on the relief of
symptoms and preservation of organs and tissues. Aggressive medical
therapy is the keystone of patient management. The most obvious is
to change the risk factors that affect disease progression. Drug
treatment includes platelet inhibitors (aspirin, Plavix),
cholesterol lowering medications, and blood pressures medications.
Non-surgical options are available to expand the lumen of the
artery, thereby increasing blood flow and decreasing symptoms. These
include balloon angioplasty and stenting. These procedures are
performed in the catheterization laboratory, usually through the leg
artery using a local anesthetic. Some patients are best served by a
surgical procedure. Most surgical procedures involve bypassing or
removing the blockage from the artery. |
