Peripheral vascular disease

Narrowing of blood vessels in the legs, and sometimes in the arms, restricting blood flow and causing pain. In severe cases, gangrene may develop. In most affected people, peripheral vascular disease is caused by atherosclerosis. The greatest risk factor is smoking. Diseases of the peripheral vessels that are not caused by atherosclerosis include Buerger’s disease, Raynaud’s disease, deep vein thrombosis, and varicose veins. The first symptom of narrowed arteries due to atherosclerosis is usually an aching feeling in the leg muscles when walking, which is relieved by resting. Pain recurs after the same amount of walking as before. Prolonged use of the arms may also cause pain. Symptoms then become worse until, eventually, pain is present even when the person is at rest and the affected limb is cold and numb. In the final stage, there is gangrene. Sudden arterial blockage may occur, causing sudden severe pain. Movement and feeling in the limb are lost. A diagnosis is often based on results of doppler ultrasound or angiography. Exercise and giving up smoking are important aspects of treatment. Arterial reconstructive surgery, bypass surgery, or balloon angioplasty may be needed. Amputation is needed for gangrene.