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The human body relies on an extensive network of blood vessels to supply oxygen–rich blood from the heart and remove waste products from the cells. Arteries are vessels that generally transport blood from the heart to the body, whereas veins are vessels that generally carry oxygen–poor blood back to the heart. Among both arteries and veins, central blood vessels are those leading directly to or from the heart, and peripheral blood vessels are those in the feet, legs, lower abdomen, arms, neck or head. The term peripheral vascular disease refers to damage or dysfunction within peripheral arteries and veins.
There are two types of peripheral vascular disease. The first type is peripheral arterial disease (PAD), which refers to diseased peripheral arteries. Peripheral arterial disease is a type of atherosclerosis, in which the arteries become hardened and narrowed. Peripheral artery disease is often named after the artery that is affected. Types of peripheral artery disease include:
- Carotid artery disease. Narrowing of one or more carotid arteries in the neck, which supply oxygen–rich blood to the brain, through atherosclerosis.
- PAD of the lower extremities (legs). Narrowing of one or more arteries in the leg (usually the femoral artery near the groin). About eight million people in the United States have lower extremity PAD, according to the American Heart Association.
- PAD of the renal arteries. Narrowing of one or more renal arteries, leading to the kidneys.
- Abdominal aortic aneurysm (AAA). The bulging or ballooning out of part of the wall of the abdominal section of the aorta, the body’s main artery that carries oxygen–rich blood from the heart to the body.
- Raynaud syndrome. A condition in which the fingers or toes start throbbing and turning a whitish color because a contraction (vasospasm) of the small arteries has interfered with blood flow.
- Buerger disease. A rare type of peripheral arterial disease that involves inflammation of the smaller arteries in the extremities and gets worse over time, causing increasing pain in the legs (claudication).
- Polyarteritis nodosa (PN). A rare and potentially deadly form of vasculitis, a condition in which small to medium–sized blood vessels (usually arteries) are abnormally inflamed. PN causes structural damage to the inside walls of the inflamed blood vessels, which reduces the flow of blood.
The second type of peripheral vascular disease is peripheral venous disorders, which refer to problems in the peripheral veins. There are a number of different peripheral venous disorders, which include:
- Thrombophlebitis (including superficial vein thrombosis and deep vein thrombosis). An obstructing blood clot (a thrombus) has formed, causing the surrounding veins to become inflamed (phlebitis).
- Varicose veins. Abnormally widened veins that are swollen, dark and frequently twisted or contorted instead of straight. They usually occur in the legs and may cause swelling (edema), inflammation and a dark color around the ankles.
- Chronic venous insufficiency. An advanced stage of leg vein disease in which the veins become incompetent, causing blood to pool in the legs and feet, and sometimes to leak backwards.
There are numerous factors that might contribute to peripheral vascular disease. Risk factors for arterial vascular disease include a family history of atherosclerosis, diabetes, obesity, smoking, high blood pressure, exposure to lead and cadmium, or kidney disease. Risk factors for peripheral venous disorders include lack of exercise, smoking, obesity and long periods of immobility such as bed rest after surgery.
Vascular disease can be diagnosed with a variety of tools, including blood pressure cuffs, Doppler ultrasound, angiogram, intravascular ultrasound (IVUS) and magnetic resonance imaging (MRI). Newer diagnostic tools include the plethysmogram and the venogram.
Peripheral vascular disease can be treated with lifestyle changes, surgery, medications such as sclerosing agents or anticoagulants, catheter-based treatments, or endoscopic vein surgery. | 
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