Peripheral Vascular Disease

Sheldon Gottlieb, M.D.

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