PERIPHERAL VASCULAR DISEASE
Poor lower extremity circulation (or medically known as peripheral vascular disease) is defined by either an insufficient amount of oxygen-rich blood (blood from the lungs/arteries) going towards the legs and feet, or not enough blood being pumped back towards the heart (insufficient veins) which causes low-oxygen red blood cells to pool in the legs and feet. It is certainly possible to have a combination of both. The main causes have to do with problems in general vascular health (plaque buildup, coronary artery disease, heart conditions, etc.), dietary, smoking, and/or may be hereditary. Symptoms generally include pain after walking a set distance/in bed, continuous lower extremity swelling, or formation of wounds.
Arterial insufficiency refers to an inadequate flow of blood from the arteries (oxygen-rich blood pumped from the heart) to the legs and feet. This tends to lead to pain after a set distance (ex a block, or several blocks). Often times, you may have to rest not because you are out of breath, but because there is severe pain in your lower extremities. Also, you may notice that if you feet and legs are elevated, there is severe pain after a set amount of time. This is because the blood supply (arteries) are not pumping strong enough to overcome gravity. If the arterial insufficiency is severe enough, then painful wound formation may also begin. The reason behind this is that the overall chronic lack of oxygen within the tissues of the lower extremities is causing normally healthy tissue to die off. The pain occurs in all the scenarios mentioned above because the nerves are not getting the appropriate amount of oxygen needed from the blood stream and are alerting you via pain.
Venous insufficiency is a term that refers to poor return of blood from the lower extremities (oxygen-poor red blood cells) back to the heart. While alone venous insufficiency tends to be less serious than arterial insufficiency, there are several long term problems that may arise. Initial symptoms typically include swelling/edema of the lower extremities. You may also notice some dark spots on your legs and feet. These are caused by deposits/pigments within the red blood cells which pooled in a certain area for an extended period of time. As the disease progresses, it can lead to formation of water blisters and cause general weeping in the legs. This is a direct cause of too much fluid within the lower extremities. With nowhere to go, the fluid eventually breaks through the skin, causing those wounds to form. If left untreated, these can easily lead to infection as they stay chronically wet (a growth medium for bacteria).
Treatment generally includes a thorough clinical exam to better assess what the underlying cause may be. We also offer a circulation test, which completely non-invasive and involves the placement of multiple blood
pressure cuffs throughout various parts of your body to compare pressures. Unfortunately, those who develop wounds due to these underlying conditions will need to have these issues addressed before proper wound healing can begin. We work very closely with some great vascular surgeons, who can further give you treatment options and help us get you on the road to recovery.
For more information, please feel free to get in touch with us.