Peripheral Vascular Disease [return to the list of articles]

Arteries are blood vessels which carry blood away from the heart to our organs and our extremities. Arteriosclerosis is the accumulation of plaque or fatty deposits in the vessels which can decrease the blood flow. This basic concept to vascular surgery was recognized over 100 years ago.

Over the past 50 years, there have been great improvements and successes with surgery improving the blood flow through arteries.

Claudication is a term used to describe extremity pain (typically of the lower extremities) due to arterial blockage. Patients experience aching or cramping with walking and with exercise. Rest pain is a symptom of more serious arterial obstruction described as pain while in a sedentary (resting) position and may be relieved by moving or dangling feet in a dependant position.

It is estimated that 10% of the population over the age of 70 have symptoms of claudication and approximately 50,000 bypass procedures are performed annually in the United States.

If you experience these symptoms, evaluation by a vascular surgeon may be in order. Diagnostic techniques such as non-invasive Doppler studies or arteriograms may be used to assess the presence or extent of the disease.

The severity of the disease and the patient's symptoms will dictate the treatment.

Initial traditional treatment centered around cessation of smoking and exercise. It is estimated that direct smoking related health costs exceed 16 billion dollars annually. Over 80% of patients incorporating this treatment have a decrease in symptoms.

Over the past 20 years, a second line of treatment has been used for peripheral vascular disease-that being medical treatment. Numerous new medications can improve the blood flow and reduce the symptoms of claudication. Minimally invasive procedures as well as conventional surgical treatment of blockages now have a very high success rate and low morbidity. Bypass surgery with veins or synthetic grafts can "bypass" or "detour" the blood flow around the area of the blockage thus restoring blood flow more distally.

The key to successful treatment is early recognition of symptoms and the coordinated efforts of your family physician and the vascular surgeon.