Peripheral Vascular Disease​

Peripheral vascular disease (PVD) is a term given to any disease of the arterial system (that is, the blood vessels) other than those related to the heart and brain. This disease is commonly caused by a narrowing of the blood vessels that transport blood to different parts of the body. When an artery is narrowed, the blood supply to the end organ (for instance the arms, legs, stomach, kidneys etc. is compromised, resulting in decline in the function of that organ. There are two types of peripheral vascular diseases:

Functional PVD: In this type of PVD, the physical structure of the blood vessels isn't damaged and you may experience spams.

Organic PVD: In this type of PVD, the physical structure of the blood vessels is damaged or structurally changed because of swelling, inflammation, tissue damage etc.

Peripheral vascular disease is commonly used synonymously with peripheral artery disease (PAD), which is the most common type of organic PVD. It involves restricted blood flow to the legs or arms because of narrowing of arteries. Fatty deposits build up inside the arteries, and if left untreated, can result in anything from extreme pain to amputation. Other causes include high blood sugar (diabetes), infection or injury. PVD leads to higher risk of stroke and heart attack. It is a common condition affecting both men and women, with smokers, diabetes patients and people with high blood pressure bearing the highest risk. Older people, especially those over the age of fifty, are more likely to contract the disease as well. ​​

Research suggests that approximately half the people suffering from PVD do not exhibit any symptoms. Often, people disregard the symptoms as signs of ageing. The symptoms of periphery vascular disease differ depending on the circumstances, such as which artery is affected, and to what extent is blood flow restricted. The usual symptoms are:

  • Leg pain, that occurs when you start walking and stops when you rest. This is caused by higher demand for blood oxygen than the available blood supply can provide. This is usually a dull pain, accompanied by cramps and/or a feeling of heaviness or tightness in the muscles.

  • Feeling of numbness or tingling in the legs

  • Cold sensation experienced in the legs or feet 

  • Change in the pallor of skin

  • A wound that doesn’t  heal

  • Impotence

  • Loss of hair on the legs

  • Slower growth of toenails

  • Painful cramps experienced in the hip, thigh and/or calf muscles​

Usually the symptoms of peripheral vascular disease manifest themselves if you are involved in a physical activity. However, at times they even show up if you are at rest, which is a more severe form of the disease and must be brought to the attention of your doctor immediately. The <Heart, Lungs and Vascular Service Line> at The Aga Khan University Hospital boasts an internationally accredited program along with highly trained staff. 

Your time with your doctor may be limited, so makes sure to prepare for your visit beforehand. Here are some tips to help get you started.

It is important to diagnose the symptoms of peripheral vascular disease as early as possible in order to begin treatment, as the disease may become life threatening if left untreated for too long. The first step in diagnosis is a complete medical history and a physical exam, including listening to your pulse with a stethoscope. A series of questions known as the Rose criteria is used to take a complete medical history. There are several other tests used in conjunction with this, which include:

  • ABI (Ankle-Brachial Index): This is one of the most common tests used to diagnose PVD. Your doctor will attach cuffs to your hand and feet and compare the blood pressure in your ankle to the blood pressure in your arm. This test can also be coupled with an exercise test to measure your blood pressure before and after exercise, to determine whether the arteries are narrowed and how they are affected by physical strain. 

  • Doppler ultrasound: In this procedure, high frequency sound waves are used to create images of your body. It is a non-invasive and painless procedure. Your doctor will check the blood flow in your vessels for abnormalities. 

  • Blood tests: Your doctor will want to check for diseases such as high cholesterol and diabetes, which are contributing factors to peripheral vascular disease.

  • Angiography: In this procedure, your doctor will insert a device known as catheter into your arteries. A contrasting dye is injected so that an X-ray image can be captured for further analysis. This device can also be used to widen up the arteries if needed.

  • CTA (Coronary Computed Tomography Angiogram)/MRI (Magnetic Resonance Imaging): A machine with a magnetic field is used to capture images of your insides. These are non-invasive and painless procedures, and preferred to invasive procedures such as angiography. ​

It is vital to receive prompt treatment for peripheral vascular disease, as it proves to be fatal if left untreated. Lifestyle changes are first and foremost steps, which can treat the symptoms in early stage of disease and also prevent risk of future complication. This includes quitting smoking, losing weight, adopting a healthy/ balanced diet and initiating a regular exercise program.

Medication may also be used to relieve the pain and restore regular blood flow. These could be used for a variety of purposes, such as lowering cholesterol and blood pressure, removing clots or controlling diabetes. Surgical options for treatment include angioplasty (inserting a long tube into the artery to widen it), bypass surgery (a procedure in which a normal healthy artery is connected to the distil healthy artery by passing the occluded segment for the vessel to restore blood flow and restore organ function), endarectomy (removing the plague from artery) or amputation of the affected limb.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage.​

​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.