Cardiovascular Center: Peripheral Vascular Disease Program

Peripheral vascular disease (PVD) is a condition that affects blood circulation in places outside of the heart and brain, such as in the arms, legs or kidneys. PVD is caused by the narrowing of blood vessels and arteries due to a buildup of plaque (fatty deposits) known as atherosclerosis. This silent, progressive process limits the blood flow that is vital for tissue and organ survival.

Some of the most commonly affected arteries are those in the legs, from your buttocks to your feet. Symptoms usually occur at the end stage of this disease when the blockage causes limited blood flow to the legs. However, almost 80 percent of people with PVD do not have any symptoms at all but are at a high risk for heart attack, stroke and death. Due to this silent process, early diagnosis is very important in preventing serious complications associated with PVD.

There are two types of PVD:

  • Functional PVDs. In this type, there are no defects or damage in the blood vessel structures. Rather, these diseases often cause vessels to spasm and other symptoms that come and go.
  • Organic PVDs. In this type, there are structural changes to the blood vessels, such as inflammation or tissue damage.

Our team of cardiovascular specialists are regional leaders in effectively diagnosing, treating and managing peripheral vascular disease. The good news is that patients who are diagnosed early and receive aggressive medical treatment may be able to avoid serious health problems.

Who Is at Risk of Developing PVD?

There are several risk factors including family history, if you are over 50 years of age or if you are African-American, particularly if you are diabetic, a smoker, or have been diagnosed with coronary artery disease. If you already had a heart attack or a stroke you should be evaluated for PVD. Other factors include being obese; having an inactive lifestyle; or if you have high blood pressure and high cholesterol. If you have one of more of these factors, your health should be actively monitored by a primary care physician and, if needed, a cardiovascular specialist. If you are over 70 years of age, you should be screened for PVD especially if you have two or more risk factors.

Symptoms of Peripheral Vascular Disease

The symptoms of PVD depend on which area of the body is affected. When a blood vessel of the leg or arm is affected, you will feel cramping, heaviness, pain or discomfort in the legs, particularly the calves, buttocks or arms with activity. You may also experience:

  • Numbness or tingling in the legs, feet or toes
  • A burning or aching pain in the feet and toes while resting, especially at night while lying flat
  • Changes in skin temperature in the legs, feet or toes
  • Loss of hair in the chin area
  • Redness or other color changes in the skin
  • Increased occurrence of infection
  • Toe and foot sores that do not heal
  • Erectile dysfunction

When PVD affects blood vessels of the kidneys, symptoms include sudden high blood pressure (hypertension) or blood pressure that is difficult or impossible to control with medication. When left untreated, PVD affecting the kidneys can result in kidney failure.

Diagnosing Peripheral Vascular Disease

Our specialists have access to the latest research in diagnosing and treating PVD and use some of the region’s most advanced technology to establish the extent of your condition. A thorough medical history and physical exam, along with an assessment of risk factors, is performed and several diagnostic tests are available to confirm the presence of PVD and determine the appropriate course of treatment. Most of these tests are non-invasive and painless, including:

  • Ankle brachial index (ABI). Blood pressure is compared in the ankle and in the arm using a regular blood pressure cuff and a Doppler ultrasound device.
  • Single-level ABI. Cuffs are placed on the upper arms and at the ankles while a Doppler (probe) is placed on the pulse at the feet to hear the sound of the artery.
  • Multi-level ABI (also called segmental ABI). Cuffs are placed on each calf, above the knees and at the thighs, in addition to the arms and ankles. This reading will help pinpoint where in the arteries the blockages occur.
  • Stress ABI. Used when patients have intermittent claudication (too little blood flow) which can cause severe cramping of leg, calves, buttocks or arm muscles as the result of exercise. After the multi-level ABI is performed, the patient is placed on a treadmill for five minutes, or until they are unable to continue walking. Pressures are recorded as soon as possible.
  • Angiography. A minimally invasive procedure that inserts a small catheter in the artery and injects dye to define the degree of blockage in your arteries. (This is the “Gold Standard” procedure.)
  • Magnetic resonance angiogram (MRA). Used to obtain images of blood vessels and their function inside the body.
  • CT Angiogram (CTA). A non-invasive procedure to define the degree of blockage with an injected dye.
  • Ultrasound imaging. A non-invasive study of the affected vessels using Doppler (high velocity sound waves) to assess the degree of blockage.
  • Pulse volume recordings (PVR). A PVR study is a noninvasive vascular test in which blood pressure cuffs and Doppler are used to get information about arterial blood flow in the arms and the legs. This information is then used to determine the presence, severity and general location of peripheral vascular disease.

Treating Peripheral Vascular Disease

By taking a whole-person approach to individualized treatment plans, our cardiovascular specialists are able to determine optimal therapies for each patient. Recommendations may include lifestyle changes, medications or in severe cases, more aggressive treatment.

  • Lifestyle Changes
    Adopting a healthier lifestyle can make a significant difference for people with PVD. Our specialists are here to help you with the right information and encouragement to make changes that can include:
    • Quitting smoking. Ask your doctor about smoking cessation programs available in your community.
    • Begin a regular exercise program, such as walking, which can aid the treatment of PVD. Patients who walk regularly can expect a marked improvement in the distance they are able to walk before experiencing leg pain. Exercising at our closely monitored cardiac rehabilitation program may be a good option.
    • Eating a high-fiber, low-fat, low-cholesterol, low-sodium diet. Limit fat to 30 percent of your total daily calories. Avoid trans fats, including products made with partially hydrogenated and hydrogenated vegetable oils.
    • Maintaining a healthy weight
    • Managing stress in a healthy way
    • Controlling diabetes by taking prescribed medications and seeing your doctor regularly
    • Controlling your blood pressure with diet, exercise and, when needed, medication
  • Medications
    A number of established and advanced medications are often used to treat PVD. These may include:
    • Statin medication to reduce your cholesterol levels.
    • Blood pressure medication to control your blood pressure.
    • Anticoagulant (anti-blood clotting) medication to help reduce your risk of blood clots.
    • Blood thinning medication to help reduce your risk of blood clots.
  • Interventional Procedures
    When other therapies are not enough and in stages of advanced PVD, interventional procedures may be needed to provide relief. These can include:
    • Angioplasty. Also known as percutaneous coronary intervention, this is a non-surgical procedure in which a interventionalist accesses narrowed arteries by using a catheter and a balloon to access the affected artery and open the blockage.
    • Stenting. A tiny mesh device taken to the affected artery with a catheter to support the cleared vessel and keep it open.
    • Atherectomy or thrombectomy. Arterial interventions that remove blockages or obstructions like plaque, calcium, or clots.
    • Bypass grafting. Bypass grafting is a procedure in which your surgeon uses an artery from your chest or wrist or a vein from your leg to bypass (go around) arteries that have been narrowed due to peripheral vascular disease.

Why Choose UF Health for Treatment of Peripheral Vascular Disease

As part of the region’s leading academic health center, the specialists who staff our Peripheral Vascular Disease Program are professors and researchers in one of the nation’s largest cardiovascular training programs.  We have leading experts in endovascular interventions using state of the art technique and technology to treat the most difficult patients and perform a large number of below the knee and limb salvage procedures. We participate in cutting edge research and have access to the latest and most innovative equipment to treat PVD with more options than other facilities, which in many cases means better outcomes for our cardiovascular patients. By staying on the leading edge of what’s coming next in cardiovascular treatment and research, our team can create a customized, effective treatment plan for each individual patient we serve.

Frequently Asked Questions

Who is at risk of developing PVD?

You are at greater risk for developing PVD if:

  • You are a diabetic
  • You are a smoker
  • You are obese
  • You have high blood pressure
  • You have high cholesterol
  • You have a family history of the disease
  • You have an inactive lifestyle
  • You have been diagnosed with heart disease
  • You have had a stroke
  • You are African-American
  • You are over 50

What are the symptoms of PVD?

While many patients will not experience symptoms of PVD, some may notice:

  • The presence of a dull, cramping pain in the hips, buttocks or calf muscles that occurs during physical activity and improves when resting (known as intermittent claudication)
  • Numbness or tingling in the legs, feet or toes
  • A burning or aching pain in the feet and toes while resting, especially at night while lying flat
  • Changes in skin temperature in the legs, feet or toes
  • Redness or other color changes in the skin
  • Increased occurrence of infection
  • Toe and foot sores that do not heal
  • Erectile dysfunction

What other problems can occur from PVD?

If left untreated, patients with PVD can develop serious health problems, including:

  • Heart attack
  • Stroke
  • Transient ischemic attack (TIA)
  • Renal artery disease or stenosis
  • Amputation

Is there a cure for PVD?

There is no cure for PVD, but by quitting smoking, exercising regularly, limiting fat and following a healthy diet, while managing your risk factors, you can help to reduce the progression of the disease.

Jacksonville Peripheral Vascular Disease Specialists

  • Patrick Antoun, M.D.
    Assistant Professor
    Medical Director, CV Center Inpatient Services
    Specializes in Cardiovascular Disease; Interventional Cardiology
  • John Pirris, M.D.
    Assistant Professor
    Chief, Division of Cardiothoracic Surgery
    Specializes in Thoracic Surgery
  • Daniel Soffer, M.D.
    Associate Professor
    Medical Director, Endovascular Cardiology
    Specializes in Cardiovascular Disease; Interventional Cardiology

Peripheral Vascular Disease Program Locations

  1. UF Health Cardiovascular Center – Emerson

    Suite 120
    4555 Emerson Street
    Jacksonville, FL 32207

  2. UF Health Cardiovascular Center – Jacksonville

    5th Floor, Ambulatory Care Center
    655 West 8th Street
    Jacksonville, FL 32209

  3. UF Health Cardiovascular Center – North

    Suite 3600
    15255 Max Leggett Parkway
    Jacksonville, FL 32218