Peripheral vascular intervention (PVI) are procedures used to treat peripheral artery disease (PAD) or atherosclerosis. The goal of PVI is to restore blood flow to the lower extremities. This restoration eliminates pain, numbness, and the need for limb amputation. Since PVI procedures are catheter-based and minimally invasive, patients who receive treatment often experience faster recovery times and fewer risks.
How is Peripheral Artery Disease Diagnosed?
Before a PVI procedure is performed, a formal diagnosis for PAD is required. This may be done using one or more of the following examination methods:
- Ankle-brachial index (ABI). The ankle-brachial index is a non-invasive test that uses inflatable cuffs to gauge blood flow in the leg, foot, and toe arteries. The ABI is calculated by dividing the ankle’s blood pressure to that of the brachial artery in the arm. If the resulting ratio is less than 0.9, it could indicate peripheral artery disease (PAD) in the patient’s legs.
- Doppler ultrasound. A doppler ultrasound is a non-invasive procedure that uses high-frequency sound waves to assess the heart’s functions and structures. The doppler ultrasound exam does not use any injections or radiation. Instead, a small microphone-like transducer is placed against the skin. As the doctor moves the device across the body, high-frequency sound waves, or echoes, are emitted from the internal tissues and organs. The echoes are converted into moving images on a screen that are analyzed by your doctor. There are no risks associated with this procedure.
- Peripheral computed tomography angiography (PCTA). A peripheral computed tomography angiography is a diagnostic imaging test that combines contrast dyes with standard CT scan technology. The PCTA is noninvasive and is extremely useful for patients who have a stent or pacemaker.
- Magnetic resonance angiography. A magnetic resonance angiography is a type of MRI that looks specifically at the body’s blood vessels. The information it provides to doctors is similar to that of a CT scan; however, MRAs use magnets instead of x-rays to produce the observed images.
What are the Treatment Options for Peripheral Vascular Intervention?
The treatment for PAD concentrates on reducing symptoms and preventing further progression of the disease. In most cases, lifestyle changes, exercise, and claudication medications are enough to slow PAD progression. In more severe cases, peripheral vascular intervention procedures may be required to treat the disease. These minimally invasive surgical options include:
- Peripheral angiogram. A peripheral angiogram, also known as peripheral catheterization, is used to detect significant blockage in the arteries of your peripheral circulation. During the procedure, a catheter is guided through the arterial system until it reaches the heart. A contrast dye is then injected under the X-ray to better visualize the arteries of the heart muscle. If a stent is required to control the blockage, it will be placed during the same procedure.
- Arterial thrombectomy. An arterial thrombectomy is used to remove a blood clot from an artery. During the procedure, a special catheter is guided through the arterial system until it reaches the clot. The clot is then aspirated and removed from the artery, which restores blood flow and relieves the patient of pain.
- Peripheral atherectomy. A peripheral atherectomy is used to eliminate the build-up of plaque in the arteries. During the procedure, a catheter with a sharp blade or laser is guided to the artery’s blockage site. The catheter breaks up the blockage into particles smaller than red blood cells so that blood can flow freely through the vessel.