Peripheral Vascular Occlusive Disease

The Vascular Surgery team at the University of Michigan is a group of world class surgeons, nurses, allied health professionals, and clinical researchers dedicated to providing exceptional patient care for Peripheral Vascular Occlusive Disease in the U-M Cardiovascular Center (CVC), our new state-of-the-art clinical building.

What is Peripheral Vascular Occlusive Disease

Peripheral Vascular Occlusive Disease (PVOD) describes a condition or set of conditions caused by the blockage or narrowing of the body's large peripheral arteries. Lack of proper blood flow to the legs is very common in this condition, with many patients experiencing leg pain with walking (claudication), which occurs as a result of the lack of oxygen to the muscle tissue.

In some patients the vascular system may compensate for the reduced blood flow by forming alternative routes, called collateral vessels, which bypass the affected vasculature.

In others, collateral vessels may not be sufficient resulting in foot pain at rest and non-healing sores on the feet.

What are the Symptoms of Peripheral Vascular Occlusive Disease?

Symptoms of PVOD include:

• Persistent or intermittent leg pain (claudication) or cramping when walking
• Numbness or loss of sensation in the affected limb
• Sores that heal slowly or fail to heal
• Differences between limbs in relation to color and/or warmth
• Decreased rate of hair and nail growth on the impacted limb
• Foot pain at rest

What causes Peripheral Vascular Occlusive Disease?

Over time, smoking, poor diet, and inactivity, in conjunction with diseases such as hypertension and diabetes, cause the vein walls to become rigid and narrow. Risk factors for PVOD include:

• Diabetes
• High cholesterol
• Hypertension

How is it diagnosed?

If PVOD is suspected, your health care provider will perform a non-invasive test referred to as an ankle brachial pressure index (ABI). The ABI measures the difference between the systolic blood pressure in your arms and the systolic pressure in your ankles. Based on the result of this test, an ultrasound may be ordered to determine the extent of the blockage. Angiography, an x-ray dye procedure, or a Computed Tomography Angiography Scan (CTA) may also be used to more precisely define the exact location of the blockage if a procedure is indicated.

How is Peripheral Vascular Occlusive Disease Treated?

The treatments for peripheral vascular occlusive disease focus primarily on risk factor reduction in conjunction with medical therapies. Surgical options are reserved for those patients who have the most severe symptoms and complications.

Risk Factor Reduction Steps:

• Stop smoking
• Walk 30 minutes, 4 to 5 times a week, stopping as needed
• Consideration of a daily baby aspirin regimen, a cholesterol-lowering statin medication (e.g. Lipitor™, Zocor™, etc...), and an ACE inhibitor for blood pressure control is also recommended, if appropriate.
• Consideration Beta-Blocker medications may be recommended.
• Consideration of Cilostozol™, a medication specifically designed to treat claudication symptoms.

In the event the disease reduces blood flow to such an extent that prevents a wound or sore from healing, or if pain occurs at rest, surgical intervention may be indicated including:

• Balloon angioplasty, with or without stent placement
• Bypass Grafting
• Cryoplasty
• Percutaneous Atherectomy
• Laser Atherectomy

What can I do to prevent Peripheral Vascular Occlusive Disease?

Because PVOD most commonly results from atherosclerosis or hardening of the arteries, you can reduce your risk for developing the condition by following these guidelines:

• Don't smoke
• If you have diabetes, see your health care provider regularly and follow all diet and medication instructions
• Lower your blood pressure if it is high
• Eat foods low in fat and cholesterol
• Lose weight if you are overweight
• Exercise regularly according to your health care provider's recommendations
• Try to reduce stress in your life

Make an appointment or contact us for more information.