Peripheral vascular disease is atherosclerosis, or "hardening of the arteries," of the extremities, most commonly the legs. This occurs as cholesterol deposits block the blood flow in the arteries, which happens as a result of the typical cardiovascular risk factors:  smoking, hypertension, diabetes, and so forth.

Peripheral vascular disease increases with age, affecting 8% of persons aged 60-69 and 19% of those 70 and older. Common symptoms include pain in the thigh or calf muscles with walking (called intermittent claudication). In severe cases, pain occurs even at rest, leg ulcers develop and will not heal, infections set in, and limb amputation sometimes becomes necessary.

Modification of risk factors is the cornerstone of treatment. Health status is greatly improved in persons who quit smoking, begin an exercise program, reduce their blood cholesterol level, and control hypertension and diabetes. Several drugs are also approved for the treatment of peripheral vascular disease.

When these and other conservative measures don't prevent the condition from becoming incapacitating or limb-threatening, vascular surgeons can perform a procedure to restore the blood flow to the extremity (called revascularization). This can be done by a surgical bypass procedure or by balloon angioplasty, the same procedures that are used to correct blockages of the coronary arteries. In the bypass procedure, surgeons create a new channel for blood to flow, bypassing the blocked section of the artery. In balloon angioplasty, the blocked artery is opened up by means of a catheter (wire) threaded through it and the inflation of a tiny balloon. Sometimes, thrombolytic drugs are injected to help break up clots.

Not all patients with peripheral vascular disease can benefit from revascularization. This depends largely on the exact location and degree of artery disease and the overall health status of the patient. But when revascularization can be done, the procedure usually provides relief of symptoms, although the results may not be permanent and symptoms may return. For this reason, it is extremely important for persons with this disease to modify their risk factors for atherosclerosis. It is essential to stop smoking and to begin a rigorous daily walking program, which helps the body develop its own natural bypass channels.