Peripheral Vascular Disease (PVD)

Condition

What is peripheral vascular disease?
Peripheral vascular disease (PVD) or peripheral artery disease (PAD) is a condition in which the arteries that carry blood to the arms or legs become narrowed or clogged. This interferes with the normal flow of blood, sometimes causing pain but often causing no symptoms at all. The most common cause of PVD is atherosclerosis (often called hardening of the arteries). Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, forming a substance called plaque that clogs the blood vessels. In some cases, PVD may be caused by blood clots that lodge in the arteries and restrict blood flow.

What are the symptoms of PVD?
The most common symptom of PVD is painful cramping in the leg or hip, particularly when walking. This symptom, also known as claudication, occurs when there is not enough blood flowing to the leg muscles during exercise. The pain typically goes away when the muscles are given rest.

Additional symptoms include:

Burning or aching pain in feet or toes when resting
Hypertension
Cold legs or feet
Color change in skin of legs or feet
Loss of hair on legs

If you have PVD you are also at higher risk for heart disease and stroke. Unfortunately, the disease often goes undiagnosed because many people do not experience symptoms in the early stages of PVD or they mistakenly think the symptoms are a normal part of aging.

How is PVD diagnosed?
The most common test for PVD is the ankle-brachial index (ABI), a painless exam in which a special stethoscope is used to compare the blood pressure in your feet and arms to determine how well your blood is flowing and whether further tests are needed. Based on the results of your ABI, as well as your symptoms and risk factors for PVD, the physician can decide if further tests are needed. When the ABI indicates that an individual may have PVD other imaging techniques may be used to confirm the diagnosis, including duplex ultrasound, magnetic resonance angiography (MRA), and computed tomography angiography (CTA).

Treatment

What type of treatment is available for PVD?
The best treatment for PVD depends on a number of factors, including your overall health and the seriousness of the disease. In some cases lifestyle changes are enough to halt the progress of PVD and manage the disease. Sometimes, medications or procedures that open up clogged blood vessels are prescribed to treat PVD. If a procedure is recommended there are several non-surgical, minimally invasive options available including:

Balloon angioplasty and stent placement
Thrombolytic Therapy
Thrombectomy

When should I consider PVD treatment?
As many as 10 million people in the U.S. may have PVD. The disease affects everyone, although men are somewhat more likely than women to have PVD. Those who are at highest risk are:

Over the age of 50
Smokers
Diabetic
Overweight
People who do not exercise
People who have high blood pressure or high cholesterol
Family history of heart or vascular disease

Our Service

The Division of Cardiovascular Imaging & Intervention provides a full range of diagnostic and image-guided interventional studies of the vascular system. This Division consists of seven full-time radiologists, all of whom are board certified in general radiology and fellowship trained with additional specialization in vascular procedures. In addition, each has extensive training in the use of x-ray equipment, x-ray dye and image interpretation.

Please see below for our Cardiovascular Imaging Interventional radiologists who specialize in diagnosing and treating PVD:

Where is PVD treatment performed?

Massachusetts General Hospital
Division of Cardiovascular Imaging & Intervention
55 Fruit Street, Gray 2 (Gray 2 Floor Map )
Boston, MA 02114

How to schedule PVD treatment
A referral from a physician is necessary to schedule an appointment for PVD.

Phone: 617-726-8314

To assist with scheduling please have the following information ready when calling:

Name and phone number of the physician ordering exam
Indication for exam
Patient Medical Record Number (MRN)

Team Approach
Members of the Cardiovascular Imaging & Intervention division are part of the Massachusetts General Hospital Vascular Center, a comprehensive center dedicated to the prevention, diagnosis, management and treatment of vascular disease. It is the only center in the country with common credentialing requirements for all medical and surgical specialists in order to ensure that our patients receive the best care. The Vascular Center brings together experts in seven clinical disciplines, including vascular interventional radiology.

Additional Information and Resources

MGH Collaborative Care

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