How is Peripheral Vascular Disease (PVD) Diagnosed?
Your doctor will diagnose peripheral vascular disease after a thorough exam that includes the following:
- Medical history - Your doctor will ask questions to determine if you have risk factors such as diabetes, heart disease, smoking, or a family history of PVD. Your doctor will also ask if you have noticed any problems with your legs or feet, such as pain or swelling.
- Physical exam -You’ll be checked for signs of PVD, such as a weak leg pulse, swelling, sores, or pale skin
- Ankle-brachial index (ABI) test - This is usually the first diagnostic test that your doctor will use. It compares blood pressure readings in your ankles and arms. An ABI of less than .9 may indicate PVD and an ABI of less than .4 often indicates severe PVD.
- Exercise ABI test - This is an ABI test that is done after you walk on a treadmill. It may help your doctor diagnose PVD if your initial ABI test is borderline.
- 6-minute walking test - This test can provide clues as to how much your PVD is affecting your day-to-day function
- Doppler ultrasound - While an ABI test can indicate whether you have PVD, it does not indicate which arteries are blocked. An ultrasound can help pinpoint areas of reduced blood flow or blockage.
- Computerized tomography angiography (CTA) - This X-ray imaging test allows your doctor to see the arteries in your legs and feet and identify blockages
- Magnetic resonance angiography (MRA) - The test provides images like a CTA without X-rays
- Peripheral angiogram - A doctor will insert a catheter into an artery and inject it with dye to show the location and extent of blood vessel blockage.
How is Peripheral Vascular Disease Treated?
The goal of peripheral vascular disease treatment is to control symptoms and stop the progression of the disease. Your medical team may recommend the following:
Your doctor may recommend the following lifestyle changes to treat some cases of PVD:
- Stop smoking
- Choose heart-healthy foods - One good option is the DASH eating plan, a plant-based diet rich in fruits, vegetables, whole grains, and low-fat dairy, and is low in sodium. It has been shown to help lower blood pressure.
- Lose weight - If you are overweight, losing just 5% of your body weight can help reduce your risk of developing certain risk factors for PVD such as high blood pressure or high cholesterol
- Stay active - This can also help you manage PVD risk factors. Your doctor may first recommend that you participate in a supervised PVD exercise program, which usually meets at least three times a week for three months.
Certain drugs can treat peripheral artery disease and/or prevent complications from occurring. These include:
- Antiplatelet medicines such as aspirin, clopidogrel, or cilostazol prevent blood clots and further artery narrowing
- Statins to lower blood cholesterol levels
- Blood pressure medications. Certain drugs, such as ACE inhibitors and angiotensin II receptor blockers (ARBs) prevent blood vessels from narrowing.
If the blood flow in one of your limbs is blocked, or almost completely blocked, you may need a more invasive procedure or vascular surgery such as:
- Angioplasty - A catheter is inserted to open a blocked artery with a tiny, inflated balloon. Sometimes, medication is inserted simultaneously to help dissolve a clot.
- Atherectomy - A catheter with a sharp blade is inserted into the blocked artery to remove plaque
- Stent - This small mesh tube can be surgically implanted to help hold open weak or narrow arteries
- Bypass surgery - If an artery is completely blocked and you experience severe symptoms, you may need this procedure. A vein from elsewhere in your body is used to reroute poor blood flow around the blocked-off artery.
- These procedures won’t cure PVD, but they will improve blood flow to the area and your overall quality of life.
There is no one primary risk factor for PVD, but the following significantly raise risk:
- Age - Most people in the United States who have PVD are over the age of 65
- Smoking - If you stop, you can lower your risk by about 75%
- Diabetes - People with this condition are four times as likely to develop PVD as people who don’t have diabetes
PVD is a lifelong medical condition, but the prognosis is good if you get a proper diagnosis and treatment. It’s vital to manage PVD, and any underlying medical conditions you might have.
No. But lifestyle changes, exercise, and appropriate medications will slow the progression, and in some cases, may even reverse symptoms of PVD.
Trust NewYork-Presbyterian for Peripheral Vascular Disease Treatment
It’s essential to be aware of symptoms and signs of peripheral vascular disease so that you can get prompt diagnosis and treatment. At NewYork-Presbyterian, our vascular specialists consider the whole patient and customize care to fit your unique needs. Contact us at 877-697-9355 to make an appointment today.