Most cases of peripheral vascular disease (PVD) occur when the blood vessels outside of your heart and brain become narrowed or blocked by the buildup of plaque, or sticky deposits of fat and cholesterol. This accumulation of vascular plaque is called atherosclerosis.

PVD — also called peripheral artery disease (PAD) — is a progressive circulation disorder that tends to advance slowly, but it also has the potential to worsen rapidly. That’s why, if you’ve been diagnosed with PVD, a comprehensive, multifaceted treatment approach is essential for reducing your risk of serious complications and protecting your long-term health. 

Read on as our skilled team of board-certified, fellowship-trained vascular specialists at Somerset Surgical Associates, LLC discuss how PVD is treated, including when you might want to consider surgery. 

PVD usually affects the lower extremities 

PVD can affect the vessels that carry oxygen-rich blood to your brain and body (arteries), the vessels that carry deoxygenated blood from your body back to your heart and lungs (veins), and the lymphatic vessels (capillaries) that transport lymphatic fluid (lymph) away from tissues and direct it back to your bloodstream. 

When any of these vessels are affected by PVD, the organs and tissues they serve can suffer. In many cases, PVD takes its worst toll on blood vessels in the lower extremities, or the legs and feet.   

PVD often progresses silently, or without causing symptoms, only giving rise to pain and other problems once it’s more advanced. Then, you might experience:

  • Painful leg cramps (intermittent claudication)  
  • Burning pain in your feet when resting at night 
  • Pins-and-needles sensations in your legs or feet
  • Leg numbness or weakness; balance problems
  • Much cooler lower-extremity skin temperature 
  • Noticeably slower leg hair and toenail growth 

Left untreated, lower extremity PVD may eventually give rise to chronic leg pain, ongoing leg swelling, shiny, itchy skin changes (venous stasis dermatitis), and slow-healing sores (ulcers) on your lower legs, ankles, or feet. 

Taking a multifaceted treatment approach

The main objectives of any PVD treatment plan are twofold: to ease or control problematic symptoms, and to halt or slow disease progression and reduce the risk of heart attack, stroke, limb amputation, and other serious PVD-related complications.  

Achieving these goals requires a comprehensive approach that typically includes:

Lifestyle modifications

As one of the most critical elements of PVD care, targeted lifestyle changes have the power to slow disease progression and lower the risk of life- and limb-threatening complications. Your plan may include smoking cessation, heart-healthy eating, weight loss, daily physical activity, and stress management.

Health management

PVD care also incorporates aggressive management of any coexisting health conditions — like high cholesterol, hypertension (high blood pressure), and diabetes — that can exacerbate PVD or hasten its progression if they remain uncontrolled.

Prescription medications 

In addition to any medications you may need to manage your cholesterol, blood pressure, and blood sugar levels, your PVD treatment plan may also include prescription medications to thin your blood (antiplatelet agents), relax your blood vessel walls, or improve your blood flow and ease symptoms of intermittent claudication. 

When is surgical treatment helpful for PVD? 

Surgery for PVD focuses on restoring blood flow in a vessel that’s partially or totally blocked, or improving circulation in an area by rerouting blood flow around a blocked vessel. Minimally invasive endovascular revascularization treatments include: 

  • Angioplasty and stent placement, or opening a narrowed or blocked vessel with a tiny balloon, and keeping it open with the placement of a stent
  • Bypass grafting, or attaching a donor blood vessel or synthetic graft to a blocked vessel to divert the flow of blood around the blockage 
  • Atherectomy, or a procedure that uses targeted laser energy (or in some cases, a special blade) to remove plaque buildup from a narrowed vessel 

Surgery is often necessary for those who need immediate treatment for severely limited blood flow to a leg or foot that raises their risk of tissue death and amputation, but PVD surgery isn’t reserved for severe, limb-threatening circumstances. 

Surgical treatment may be a good option for you if you have severe leg pain or other PVD symptoms that interfere with your daily life, even after several months of exercise, dietary changes, and medication. You may want to consider surgery if:

  • You have persistent pain at rest
  • Your symptoms restrict your mobility
  • Your symptoms limit your activities
  • You have a non-healing skin ulcer 

If you’re considering surgery, our team discusses your options, explains the pros and cons of each, and gives you the guidance you need to make an informed choice — the one that’s right for your personal preferences and your long-term health needs.   

Do you have questions about your PVD treatment options? We have answers. Call or click online to schedule a visit with one of our seasoned vascular specialists at Somerset Surgical Associates, LLC in Somerville and Hillsborough, New Jersey today.


We accept most insurance providers. If you have specific questions regarding your coverage, please contact us for additional information.

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