PERIPHERAL VASCULAR DISEASE The circulatory system consists of a network of blood vessels that include the heart, arteries, veins, and capillaries. Oxygen-rich blood is pumped from the heart and carried by the aorta and arteries to all parts of the body. The aorta is the main artery of the body. Blood flows from arteries to veins through tiny connecting blood vessels called capillaries. The veins return the blood to the heart and lungs to be enriched with oxygen and repumped by the heart. This system provides the necessary nourishment and oxygen to all body cells.
Peripheral Vascular Disease is a term used to describe a circulation disorder that affects any of the blood vessels outside of the heart and brain as well as disease of the lymph vessels. It is most often a narrowing of the blood vessels that is associated with atherosclerosis or hardening of the arteries. However, chronic inflammatory conditions, tissue injury, or spastic conditions such as Raynaud's disease can also cause this. As the average age of our population increases, so does the prevalence of vascular disease.
Atherosclerosis is caused when fatty substances such as cholesterol build-up inside the arteries, eventually building to create a narrowed or blocked opening with reduced or blocked blood flow as the result. This occurs most commonly in the iliac arteries (lower abdomen-leading to the legs), the femoral and popliteal arteries (legs), the renal arteries (kidneys), and the carotid arteries (in the neck leading to the brain).  RISK FACTORS Vascular disease includes a multitude of disorders involving blood vessels, but most are due to a process known as atherosclerosis. In atherosclerosis, fat and cholesterol are deposited in the inner walls of arteries throughout the body and is the most common arterial disease in the United States. By studying the people who already have atherosclerosis, healthcare providers are able to predict who is most likely to develop vascular disease. These at-risk people usually have one or more of the risk factors listed below. It is important to note that all of the items, except family history, are areas where you have some control. By maintaining a healthy weight and diet, exercising regularly, controlling your blood pressure and not smoking you greatly reduce your risk of developing atherosclerosis. Risk factors in the development of vascular disease include the following:
GENERAL SYMPTOMS OF PERIPHERAL VASCULAR DISEASE When oxygen is restricted to the organs and muscles in the body, they become starved for oxygen and usually send out warnings by producing pain or other symptoms in the affected area. The following are examples of commonly occurring symptoms:
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Legs-If the blockage occurs in the legs, the resulting symptom is a cramping sensation with exercise or walking in the area of the hips, thighs, or calf muscles. This can result in severely limiting the amount and distance a person walks. There is sometimes coldness, paleness, or even decreased hair on the legs while others complain of dry skin, numbness, or tingling sensations in their affected part.
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Carotids-When the peripheral vascular disease is in the carotid arteries one may experience a sudden temporary weakness or numbness in the face, arms, or leg on one side of the body or unexplained dizziness, trouble speaking or understanding, decreased vision or unsteadiness.
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Renal Arteries-When there are symptoms of vascular disease in the renal arteries there usually is no pain, only consistently elevated blood pressure that is difficult to control with medications as well as abnormal kidney function blood tests.
THE FOUR MOST COMMON EXAMPLES OF PERIPHERAL VASCULAR DISEASE
1. Carotid Artery Disease: Accumulation of atherosclerotic plaque in the carotid arteries is one of the leading causes of stroke. This process can be readily diagnosed by ultrasound examination of the vessels. Treatment may consist of medication or surgical removal of the plaque.
2. Lower extremity Arterial Disease: The arteries of the legs may develop obstructive plaque. This may result in cramping of the legs with exertion, a process referred to as claudication. In more extreme cases, pain at rest or non-healing wounds may develop. This condition can be readily diagnosed by physical examination or non-invasive pressure and blood flow measurements. In some cases, an angiogram of the leg arteries may be required for diagnosis. When symptoms are significantly limiting, the patient has non-healing wounds, or symptoms at rest, angioplasty or surgical bypass may be recommended.
3. Renovascular Disease: Renovascular disease refers to disease of the arteries of the kidney with narrowing or blockage most often due to atherosclerosis. This disease process may result in severe hypertension or some loss of kidney function. It may affect one or both kidneys and can result in permanent kidney failure that will require dialysis. Diagnosis of renovascular disease is usually by ultrasound. Treatment is with medications or angioplasty and often stent placement in the vessel. Surgery may also be necessary.
4. Aneurysmal Disease: An aneurysm refers to an abnormally enlarged segment of a blood vessel, usually an artery. The artery most often affected is the aorta, the main artery arising from the heart and usually occurs in the abdomen. Aneurysms are prone to rupture, a life-threatening event. Risk of rupture is directly related to the size of the aneurysm. Ultrasound or CT scan is used to diagnose aneurysms and also to track the growth of small aneurysms. Surgery is the treatment.
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