Peripheral vascular disease

peripheral vascular disease

1. PERIPHERAL VASCULAR DISEASE Shemil Clinical instructor DM WIMS

2. Definition Peripheral vascular disease (PVD) is a circulation disorder that causes narrowing of blood vessels to parts of the body other than the brain and heart.

3. There are two types of PVD Functional PVDs don’t involve defects in blood vessels’ structure. (The blood vessels aren’t physically damaged.) These diseases often have symptoms related to “spasm” that may come and go .(Raynaud disease) Organic PVDs are caused by structural changes in the blood vessels. Examples could include inflammation and tissue damage .(peripheral artery disease)

4. Raynaud disease Peripheral artery disease

5. Causes Atherosclerosis Blood clots Diabetes Inflammation of the arteries or arteritis Infection(salmonellosis and syphilis  ) Structural defects Injury

6. Atherosclerosis

7. Blood clot

8. Diabetes

9. Vasculitis

10. Injury

11. Risk factors Family history of heart disease, high blood pressure, high cholesterol, or stroke Older than 50 years Overweight or obesity Inactive lifestyle Smoking Diabetes High blood pressure High cholesterol or LDL plus high  triglycerides and low HDL

12. Symptoms Dull , cramping pain in one or both calves, thighs, or hips when walking, called intermittent claudication B uttock pain, N umbness or tingling in the legs, W eakness , burning or aching pain in the  feet or toes while resting. A sore on a leg or a foot that will not heal, O ne or both legs or feet feel cold or change color (pale, bluish, dark reddish), Hair loss on the legs, and Impotence.

13. Diagnosis

14. Edinburgh claudication questionnaire. Ankle brachial index(ABI). Treadmill exercise test. Angiography , or arteriography Doppler ultrasound flow studies Magnetic resonance imaging

15. Edinburgh claudication questionnaire

16. Ankle/brachial index (ABI) This test compares the blood pressure in the arm (brachial) with the blood pressure in the legs. In a person with healthy blood vessels, the pressure should be higher in the legs than in the arms. An ABI above 0.90 is normal; 0.71-0.90 indicates mild PVD; 0.41-0.70 indicates moderate disease; and less than 0.40 indicates severe PVD.

17. Treadmill exercise test   If necessary, the ABI will be followed by a treadmill exercise test. Blood pressures in your arms and legs will be taken before and after exercise (walking on a treadmill, usually until you have symptoms). A significant drop in leg blood pressures and ABIs after exercise suggests PVD

18. Angiography, or arteriography Doppler ultrasound flow studies Magnetic resonance imaging

19. Lifestyle changes S topping smoking (smokers are 4 times more likely to get PAD and have symptoms of PAD than nonsmokers.) • Controlling diabetes • Controlling blood pressure • Being physically active • Eating a diet low in saturated fats

20. Medicines Antiplatelet agents to prevent blood clots • Cholesterol-lowering medicine. • Anti hypertensive.

21. Vascular surgery A bypass graft using a blood vessel from another part of the body or a tube made of synthetic material is placed in the area of the blocked or narrowed artery to reroute the blood flow

22. Vascular bypass graft

23. Angioplasty Balloon angioplasty (a small balloon is inflated inside the blocked artery to open the blocked area ). Atherectomy (the blocked area inside the artery is "shaved" away by a tiny device on the end of a catheter) Laser angioplasty (a laser is used to "vaporize" the blockage in the artery) Stent (a tiny coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open)

24. Balloon angioplasty

25. Atherectomy

26. Laser angioplasty

27. Stent

28. Complication Amputation (loss of a limb) Poor wound healing Restricted mobility due to pain or discomfort with exertion Severe pain in the affected extremity Stroke (three times more likely in people with PVD

29. Prevention Smoking cessation, including avoidance of second hand smoke and use of any tobacco products. Dietary changes including reduced fat, cholesterol, and simple carbohydrates (such as sweets), and increased amounts of fruits and vegetables, Weight reduction Exercise plan of a minimum of 30 minutes daily Control of diabetes Control of high blood pressure