Patients with diabetes are 3 times more likely to develop PVD than non diabetic patients. Peripheral vascular disease is the reduction of blood flow to the muscles due to plaque. Plaque is a buildup of fat and cells that forms on the blood vessel walls, decreasing the space in the vessels for the blood to travel through. This results in a reduced amount of nutrient carrying blood reaching the muscles.

Risks

• Smoking
• Hypertension
• High cholesterol
• Over age 50yr

Symptoms

• Cramping of the leg muscles
• Muscle weakness and fatigue
• A sensation of heaviness in the legs
• Intermittent claudication
  • pain in legs during activity which goes away after activity stops
• Ulcers
  • open wounds which can lead to infection and limb amputation is not treated properly

Treatment

• Lifestyle changes
  • Stop smoking
  • Low fat, low cholestrol diet
  • Exercise
• Glucose control
• BP control
• Treatment of high cholesterol with statins
• Medications that inhibit platelt aggregation (prevent clot from forming)
• Medications that decrease blood thickness
• Atherectomy: surgical procedure where a catheter is inserted into the artery and then the plaque is removed from the vessel wall using a drill or balloon technique

Tests

• ABI (ankle brachail index) is used to measure the flow of blood in your limbs
  • Blood pressure cuff is placed on your ankle and bicep
  • The highest pressure recorded at the ankle is divided by the highest pressure at arm
  • Normal resting ankle bracial index is >1.0
  • Abnormal is <0.9 which signifies decreased blood flow
• Treadmill Test: check ABI before and after walking on treadmill to examine extent of symptoms
• Arteriogram: dye is injected into the artery to show blood flow through the vascular system. Often used to pinpoint the exact location of a blocked vessel