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Peripheral Vascular Disease

718.780.7830

Peripheral vascular disease (PVD) can affect the arteries, the veins or the lymph (clear fluid that carries white blood cells through the body) vessels. The most common and important type of PVD is peripheral arterial disease, or PAD, which affects about 8 million Americans.

  • PAD is more common in older people
  • People with PAD have a four to five times higher risk of heart attack or stroke.

What is Peripheral Vascular Disease (PVD)?

This refers to diseases of blood vessels outside the heart and brain. It's often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys. There are two types of these circulation disorders:

  • Functional peripheral vascular diseases don't have an organic cause. They don't involve defects in blood vessels' structure. They're usually short-term effects related to "spasm" that may come and go.
  • Organic peripheral vascular diseases are caused by structural changes in the blood vessels, such as inflammation and tissue damage. Peripheral artery disease (PAD) is an example. It's caused by fatty buildups in arteries that block normal blood flow.

What is Peripheral Artery Disease (PAD)?

In PAD, fatty deposits build up in the inner linings of the artery walls. These blockages restrict blood circulation, mainly in arteries leading to the kidneys, stomach, arms, legs and feet. In its early stages a common symptom is cramping or fatigue in the legs and buttocks during activity. Such cramping subsides when the person stands still. This is called "intermittent claudication." People with PAD often have fatty buildup in the arteries of the heart and brain. Because of this association, most people with PAD have a higher risk of death from heart attack and stroke.

How is PAD diagnosed?

Doctors at NYM will perform tests and gather information from you in order to diagnose the problem. This process includes a medical history, physical exam, ultrasound, X-ray angiography and magnetic resonance imaging angiography (MRA).

How is PAD treated?

Most people with PAD can be treated with lifestyle changes, medications or both. Lifestyle changes to lower your risk include:

  • Stop smoking (smokers have a particularly strong risk of PAD).
  • Control diabetes.
  • Control blood pressure.
  • Be physically active (including a supervised exercise program).
  • Eat a low-saturated-fat, low-cholesterol diet.


PAD may require drug treatment, too. Drugs include:

  • medicines to help improve walking distance (cilostazol and pentoxifylline).
  • antiplatelet agents.
  • cholesterol-lowering agents (statins).

Other Forms of Treatment Carried Out at NYM

In a minority of patients, lifestyle modifications alone aren't sufficient. In these cases, angioplasty or surgery may be necessary.

Angioplasty is a non-surgical procedure that can be used to dilate (widen) narrowed or blocked peripheral arteries. A thin tube called a catheter with a deflated balloon on its tip is passed into the narrowed artery segment. Then the balloon is deflated and the catheter is withdrawn.

Often a stent — a cylindrical, wire mesh tube — is placed in the narrowed artery with a catheter. There the stent expands and locks open. It stays in that spot, keeping the diseased artery open.

If the narrowing involves a long portion of an artery, surgery may be necessary. A vein from another part of the body or a synthetic blood vessel is used. It's attached above and below the blocked area to detour blood around the blocked spot.

All of these services are conducted at NYM. To learn more, call 718.780.7830.


For the Institute for Vascular Medicine and Surgery, call 866.438.VEIN (866.438.8346).

 


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