Peripheral Vascular Disease [return
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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
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