Johns Hopkins Diabetes Guide
Peripheral Vascular Disease
DEFINITION
- Peripheral vascular disease (PVD) includes disorders of the blood vessels (arteries and veins) outside the heart and brain. Persons with diabetes are especially at risk for ischemia in arteries of the legs and feet, termed "lower extremity peripheral artery disease (PAD)".
- Claudication is defined as limb pain with activity. It is due to muscle ischemia caused by arterial insufficiency.
- Critical Leg Ischemia (CLI) is defined as rest pain, ulcerations, or gangrene, with expectation of threatened limb loss within 6 months.
- "Diabetic Foot Syndrome" includes the combined effect of vascular and neuropathic (foot ulcer) injuries that lead to lower-extremity amputations[19].
- Major cause of PAD is atherosclerosis but many conditions, including venous insufficiency, mimic symptoms of PAD -- these are called "pseudoclaudication"; see "differential diagnosis" below.
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Last updated: August 1, 2017
Citation
Gottlieb, Sheldon. "Peripheral Vascular Disease." Johns Hopkins Diabetes Guide, The Johns Hopkins University, 2017. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547119/1/Peripheral_Vascular_Disease.
Gottlieb S. Peripheral Vascular Disease. Johns Hopkins Diabetes Guide. The Johns Hopkins University; 2017. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547119/1/Peripheral_Vascular_Disease. Accessed September 28, 2025.
Gottlieb, S. (2017). Peripheral Vascular Disease. In Johns Hopkins Diabetes Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547119/1/Peripheral_Vascular_Disease
Gottlieb S. Peripheral Vascular Disease [Internet]. In: Johns Hopkins Diabetes Guide. The Johns Hopkins University; 2017. [cited 2025 September 28]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547119/1/Peripheral_Vascular_Disease.
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