pAVK

PAVK, referring to peripheral arterial disease, is a common circulatory condition in which narrowed arteries reduce blood flow to the limbs, most often the legs. The most common underlying cause is atherosclerosis, though other factors such as inflammation or blood flow abnormalities can contribute. Risk factors include smoking, diabetes, high blood pressure, high cholesterol, aging, and a family history of cardiovascular disease. PAVK is often a sign of widespread atherosclerosis and is associated with an increased risk of heart attack and stroke.

Symptoms vary; many people have no symptoms initially. The most characteristic symptom is intermittent claudication, leg pain or cramping triggered by walking that improves with rest. As disease progresses, symptoms can include leg numbness or weakness, cold or pale legs, slowed nail growth, non-healing wounds, or, in severe cases, pain at rest or critical limb ischemia.

Diagnosis commonly starts with the ankle-brachial index (ABI), a simple comparison of blood pressure in the ankle and arm. An ABI below 0.90 suggests PAD. Additional tests such as Doppler ultrasound, computed tomography angiography, or magnetic resonance angiography may map arterial blockages and guide treatment.

Management focuses on symptom relief, cardiovascular risk reduction, and prevention of progression. Lifestyle changes, supervised exercise therapy, smoking cessation, and control of diabetes, hypertension, and lipids are foundational. Antiplatelet therapy and statins reduce cardiovascular risk. Revascularization via endovascular procedures (angioplasty with or without stenting) or bypass surgery is considered for lifestyle-limiting symptoms or critical limb ischemia when conservative therapy is insufficient.