Peripheral Vascular Disease
Peripheral vascular disease refers to narrowing of the peripheral arteries, most often in the legs, due to a build up of fatty deposits or plaques. It develops slowly over years and many sufferers do not recognise the symptoms. The commonest symptoms are heaviness or pain in the legs on walking which may be relieved by resting for a while. This is what is known as ‘intermittent claudication’ which can be thought of as ‘angina of the leg’. More serious peripheral arterial disease may result in pain at rest or even leg ulcers. People most at risk are smokers or ex-smokers, diabetics, those with high blood pressure or raised cholesterol and patients with a family history of peripheral vascular disease, heart disease or stroke.
Radiology is very helpful in the detection of peripheral vascular disease and Interventional Radiology offers many minimally invasive treatments that may avoid the need for more invasive by-pass surgery. The leg arteries can be scanned quickly and easily using doppler ultrasound. In certain cases a CT scan or MRI scan may be necessary, particularly if intervention is planned.
Narrow arteries detected on scanning can be opened up again by a procedure called angioplasty when a balloon is passed over a guidewire under x-ray guidance through the narrowing. The balloon is then inflated and blood flow to the limb improved. Even many complete blockages (occlusions) can be re-opened. In certain cases the artery may recoil or narrow down again following angioplasty and in these cases the Interventional Radiologist can place a stent, a small metallic tube that is deployed under x-ray guidance and stays in place permanently to hold the artery open. All of these procedures are performed via a tiny needle puncture in the groin or the arm under local anaesthetic. In many cases the patient can have these procedures safely as a day case.
Vascular disease can occur at many locations in the body but almost all can be reached using minimally invasive techniques. Dr Harding will discuss your particular case carefully with you to explain what the technical possibilities are as well as the relative advantages/disadvantages.
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