Peripheral vascular disease

Atherosclerosis is one of the etiologies of peripheral vascular disease (PVD) and is associated with specific risk factors, including diabetes mellitus, hypertension, hypercholesterolemia, and tobacco use. PVD evolves from lipid deposits at sites of vessel injury that form plaques along the intimal lumen. Further lipid accumulation and hemorrhage into these plaques ultimately result in narrowing of the arterial wall and inadequate blood supply to tissues distal to the lesion. These lesions frequently occur at major arterial bifurcations. Claudication. Claudication is the clinical description for functional ischemia. It is characterized by reproducible lower-extremity muscle pain induced by a defined amount of activity and relieved by rest. The symptoms result from the inability of the vasculature to provide blood flow commensurate with the metabolic demand of the exercising tissue. A subset of patients with claudication will go on to develop pain at rest or critical ischemia. In this circumstance, arterial perfusion is inadequate to meet the resting demands of tissue, which is an indication for surgical intervention.