Peripheral Vascular Disease (Intermittent Claudication)

27th November 2006 at 11:01 GMT by Dr.C.A.Jenner MB BS, FRCA. Permalink.

Article on the clinical features and treatment of Peripheral Vascular Disease (Intermittent Claudication)

Introduction

Peripheral vascular disease (PVD) is a medical condition characterized by narrowing of the lumen of arteries in the legs, causing a reduction in circulation to the toes, feet and legs. This disorder can affect both the legs but is often more severe on one side.

PVD is recognized as the most common disease of arteries and is referred to as coronary heart disease when the arteries of the heart are also affected.

Also known as the peripheral arterial disease (PAD) or arteriosclerosis, this condition affects at least 12-20 percent of Americans who are 65 years and older.

Key Symptoms

Peripheral vascular disease is characterized by a typical set of symptoms. Here we list the few main amongst them:

• Leg pain, occurring with exercise and subsiding with rest (claudication)
• Pain in the ball of the foot or toes
• Numbness of the legs or feet at rest
• Ulcers or sores on the foot, toes or ankles, that remain unhealed
• Bluish or black discoloration of toes
• Cold feet or legs
• Muscle pain in thighs, calves or feet
• Loss of hair on legs or feet
• Change of color of legs
• Cyanosis (paleness or blueness)
• Pulse, weak or absent in the limb
• Walking abnormalities

Causative Factors

Diabetes is regarded as one of the most common causes of PVD. Some of the other prominent causative factors are:

• Smoking
• Hypertension
• High cholesterol or blood pressure
• Family history of heart or vascular disease
• Being overweight
• Diet high in fat and/or low in antioxidant vitamins C and E
• Lack of exercise
• Age over 50

Remedial Measures

The foremost aim of the treatment plan for peripheral vascular disease is to control risk factors by bringing in certain lifestyle changes.

Here we list some of the main treatment options advised for patients with peripheral vascular disease:

1. Medications

   These are aimed at reducing the risk of heart attack and stroke. The commonly prescribed drugs are:

   • Antiplatelet drugs, such as aspirin
   • Anticoagulants, such as heparin and warfarin
   • Cholesterol-lowering drugs including niacin, statins, fibrates and bile acid sequestrants
   • Calcium channel blockers
   • Vitamins (B-6, B-12 and folate)

2. Surgery

   • Endarterectomy
   • Grafting or bypass

3. Endovascular Therapy (from within the blood vessel)

   • Angioplasty and Stenting

4. Self care

   Since the incidence of the disorder is quite high in people who have diabetes and those who smoke, certain specific lifestyle changes and self-care measures are also warranted. The main ones recommended are:

   • Reduce smoking
   • Wear proper footwear
   • Exercise regularly
   • Eat a healthy diet rich in antioxidants and low in fat
   • Keep the blood pressure and cholesterol level under control

   Alternate therapies such as herbal treatments have also known to be useful in this condition.