Peripheral Vascular Disease

Peripheral vascular disease refers to diseases of the blood vessels outside the heart and brain. Four main conditions are considered within this chapter: peripheral arterial disease, abdominal aortic aneurysm, dissection of the thoracic aorta and carotid artery stenosis.

Peripheral arterial disease (PAD) occurs when fatty deposits (atheroma) build up in the inner walls of these arteries and affect blood circulation, most commonly in the arteries to the legs and feet. It can present without symptoms, but often presents as pain on walking (intermittent claudication), pain at rest, or limb threatening reductions in blood supply (acute or chronic limb ischaemia). The latter can lead to amputation. The major preventable risk factors for cardiovascular disease are implicated in peripheral arterial disease. PAD is an independent risk factor for heart disease and stroke. Early detection and treatment, with a focus on secondary prevention including treatment of high blood pressure and high cholesterol reduces the risk of cardiovascular death and limb amputation and improves quality of life.