Overview of Peripheral Arterial Disease

(Peripheral Vascular Disease)

ByKoon K. Teo, MBBCh, PhD, McMaster University
Reviewed/Revised Jul 2023
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Peripheral arterial disease results in reduced blood flow in the arteries of the trunk, arms, and legs.

    Most often, doctors use the term peripheral arterial disease to describe poor circulation in the arteries of the legs that results from atherosclerosis. However, peripheral arterial disease can affect other arteries, such as those in the arms, and can have other causes. Disorders of arteries that supply the brain with blood are considered separately as cerebrovascular disease. Disorders that reduce blood flow of arteries in the abdomen are considered separately as abdominal aortic branch occlusion.

    Causes

    Peripheral arterial disease may be described as

    Occlusive peripheral arterial disease is due to something that physically narrows or blocks arteries. The most common cause is atherosclerosis caused by buildup of plaque in the walls of the arteries. Plaque is made up of cholesterol, fatty material, and fibrin (a clotting protein). Fibromuscular dysplasia is an example of occlusive peripheral arterial disease caused by abnormalities in the cells in the vessel wall.

    In functional peripheral arterial disease, blood flow is decreased because the arteries do not function properly. Usually the dysfunction involves a sudden, abnormal contraction of the muscles (spasm) within the walls of the blood vessels. The spasm causes a temporary narrowing that reduces blood flow. More rarely, the condition is due to abnormal relaxation of the muscles within the walls of the blood vessels, leading to a widening (vasodilation) of arteries. Acrocyanosis, erythromelalgia, and Raynaud syndrome are examples of functional peripheral vascular diseases.

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