In some cases, a person with peripheral vascular disease may not have any symptoms until the condition is advanced and severe. Symptoms may include:

• Intermittent pain (claudication), which may feel like cramps, muscle fatigue or heaviness (usually in the legs)

• Worsening pain during exercise (usually in the legs)

• Easing of pain at rest (usually in the legs)

• Coldness of the affected body part

• Numbness

• Pins and needles

• Muscular weakness

• Blue or purple tinge to the skin

• Wounds that won’t heal (vascular ulcers)

• Blackened areas of skin or skin loss (gangrene).

We recommend discussing any symptoms with your GP who can refer you to Dr Bray for full assessment and diagnosis.

In most cases the cause of Peripheral Vascular Disease is Atherosclerosis (a build up of fatty deposits within a blood vessel) that reduces blood flow to the area.

Other causes of peripheral vascular disease include:

• Diabetes – High blood sugar damages and weakens blood vessels, causing them to narrow.

• Obstruction – A blood clot (thrombus) may lodge within the blood vessel.

• Infection – Can cause scarring and narrowing of the blood vessels.

• Arteritis – Inflammation of arteries. Some autoimmune diseases can cause arteritis.

• Blood vessel defects – Blood vessels may be unusually narrow.

• Blood vessel spasms – Conditions including Raynaud’s Disease may cause narrowing of blood vessels in response to certain factors, including cold temperatures or stress.

These include:

• Diabetes – this is the most significant risk factor

• Cigarette smoking

• Advancing age

• Family history of peripheral vascular disease, stroke or coronary artery disease

• Medical history of stroke, cardiovascular disease or heart attack

• Overweight or obesity

• Sedentary lifestyle

• High blood pressure (hypertension)

• High blood cholesterol (hypercholesterolaemia).

Diagnosis of peripheral vascular disease includes:

• Medical history

• Physical examination

• Family history

• Using a stethoscope to listen for signs of reduced blood flow through a blood vessel

• Ankle Brachial Indices (ABI’s), which compare the blood pressure readings of the arms and legs to check for differences

• Exercise test, usually performed on a treadmill while blood pressure is taken to detect decreases in blood pressure in the affected body part during exercise

• Non-Invasive Vascular Duplex (doppler ultrasound)

• Magnetic Resonance Imaging (MRI) to locate narrowed sections of blood vessels

• CTA/Angiography, the injection of a contrast dye into the blood vessel that will show areas of constriction on x-ray examination.

https://anzsvs.org.au/patient-information/assessment-of-vascular-disease/

Treatment options may include:

• Best Medical Therapy to manage known vascular risk factors, prevent the complications of atherosclerosis, and slow its progression:

  • Medications to help with smoking cessation

  • Lipid lowering drugs such as statins

  • Antithrombotic drugs to prevent clots such as Aspirin

  • Antihypertensive drugs to reduce blood pressure

  • Diabetic medications to reduce sugars

• Drugs to treat blood clots – Anticoagulants and Anti-platelet drugs to prevent blood clots from developing, and Thrombolytics to dissolve blood clots.

• Angioplasty – Endovascular procedure usually performed under sedation and local anaesthetic. Involves threading a thin tube (catheter) into the narrowed blood vessel through a small incision. Once the catheter reaches the narrowed or blocked site, a small balloon on its tip can be inflated to widen the blood vessel and improve blood flow.

  • Read more: https://anzsvs.org.au/patient-information/angiograms-and-angioplasty/

• Stenting - A metal ‘sleeve’ that is implanted inside the narrowed blood vessel during an angioplasty procedure to hold it open. Stents may be impregnated with medications that help to prevent scar tissue from narrowing the treated area of blood vessel.

• Atherectomy – Cutting away the fatty obstruction.

• Bypass surgery – Usually only performed in severe cases that do not respond to other treatments, or where extensive areas of a blood vessel is diseased. Blood flow is re-routed around a blockage.

Lifestyle changes are an important part of treatment. Be guided by your doctor, but general preventative measures include:

• Take steps to properly manage risk factors, such as diabetes or high blood pressure, as advised by your doctor.

• Quit smoking.

• Exercise regularly. Ask your doctor for advice on appropriate activities.

• Eat a low-fat, high-fibre diet.

• Maintain a healthy weight for your height and build.

• Take care of injuries to affected areas, for example, dress wounds promptly and seek medical attention if wounds are not healing.

• Take all medications strictly as prescribed.

• See your doctor for regular check-ups.

• See your doctor if you have symptoms of infection in the affected body part.