Peripheral vascular disease (PVD) Dr Rob Hicks Smoking is one of the greatest risk factors of PVD, which causes a narrowing of the arteries.

In this article

What is peripheral vascular disease (PVD)?

Causes and risk factors

Treatment and recovery

PVD is a narrowing or blockage of the arteries that produces an intermittent pain in the legs or arms, known as intermittent claudication. If left untreated, amputation of the limb may eventually be necessary.

To perform well during any increased level of activity, muscles need more oxygen and nutrients. If an artery carrying oxygen and nutrients in the blood is narrowed, the muscles cannot get enough oxygen, especially while actively exercising, and pain occurs. This pain is called intermittent claudication.

If the narrowing of the arteries is severe, the pain may start after walking only a few metres. The cramping, vice-like leg pain forces sufferers to rest until it passes.

Atherosclerosis is the process by which the arteries become narrowed, or 'furred up'. Smoking, high blood pressure and high cholesterol all contribute to the development of thick plaques on the inside of the blood vessels that narrow the space available for the blood to flow through.

Smoking is the greatest risk factor for PVD. It's believed the process of atherosclerosis and artery narrowing is almost guaranteed to begin in anyone who has smoked regularly for more than a few months.

Other contributing risk factors include:

• Diabetes.
• Inactivity.
• Diet that is high in fat and low in the antioxidant vitamins C and E.

The aims of treatment are two-fold – to help the patient walk without pain and to minimise further damage to the vessels and avoid any complications.

Daily exercise helps by encouraging the development of a collateral circulation. These are smaller new blood vessels that grow to improve blood flow to the muscles and provide them with the blood supply they need. Patients are advised to walk until the pain occurs, walking through the pain if possible, or rest until it subsides, then walk again.

A low-fat diet that contains antioxidant vitamins C and E should be adopted - eating five portions of fruit and vegetables each day may help keep the blood vessels healthy. A person with PVD should be working with their doctor to actively manage problems such as high cholesterol, high blood pressure or diabetes which all contribute to the damage to the arteries.

Doctors may also recommend aspirin because it helps to thin the blood and prevent further clots forming and blocking the arteries. Other medicines may be prescribed in an attempt to improve circulation.

The use of herbal treatments may help to improve poor circulation, although there is only limited scientific research to support this. As with any herbal treatments, it's important to consult with the pharmacist or doctor before taking them, particularly when the individual is taking other medicines prescribed by their doctor or purchased from their pharmacist.

In some situations, depending on which part of the artery is diseased, it's possible to widen the narrowed part of the artery. This process is called angioplasty and is done by inflating a small balloon in the narrowed portion of the artery.

When the narrowing is more extensive and involves more than one part of the artery, it may need to be bypassed. This is done by grafting a vein from the leg or a synthetic material designed specially for this purpose.

In severe cases, when the blood supply can't be restored to a limb and there is unacceptable pain or gangrene developing, it may need to be amputated.

This article was last medically reviewed by Dr Trisha Macnair in July 2009.