Lower leg Peripheral Vascular Disease (PVD) is a common syndrome that affects a large proportion of adult populations worldwide, with a prevalence over 10 per cent in people aged more than 40 years. Apart from the age, it is a common threat to patients with associated risk factors like Coronary Artery disease, smoking, diabetics", says Dr Shirish (MS) Hiremath, director, Dept of Cardiology and Endovascular Intervention, Ruby Hall, Pune.

Marking the occasion of World Vascular Day, Dr Shirish (MS) Hiremath, interventional cardiologist, organised a one–day free, interactive programme on public awareness, elaborating the vascular ailments at SM Joshi Hall.

Diabetics, who experience leg pain when they walk, pain or numbness in the legs or feet, or cramps and muscle fatigue in the legs, may be suffering from Peripheral Vascular Disease (PVD) or lower leg PVD, a common, but under–diagnosed condition. This is affecting millions of people and has proved to be a major cause behind stroke and heart attacks.

Fortunately the lower leg PVD, if detected and treated early, can usually be resolved. As an aid to family doctors and in order to better identify and treat patients at risk for PVD, a new initiative has been taken by department of vascular and endovascular intervention, Ruby Hall clinic in conjunction with vascular specialists. This new initiative aims to raise awareness and knowledge of PVD in general practice as well as increasing the awareness of this little known disease among the general public. "The more people know about the disease, the greater the chances are of preventing disability and other serious consequences," says Dhanesh Kamerkar, vascular surgeon, RubyHall, Pune.

Similar to cardiovascular disease PVD is caused by atherosclerosis, which occurs when fatty deposits or plaque builds up on the inside walls of the arteries causing them to narrow and harden. Blocked arteries in the leg reduces the blood flow so that the surrounding muscle do not get enough oxygen, which causes the leg muscle to cramp and causes pain upon walking or exercise and that disappears on resting. This is called Intermittent Claudication. Other symptoms of PVD in the lower limb include: weakness in the leg, numbness, tingling, coldness, change in the skin colour, rash, marks or ulcers on the leg or feet. The skin on the lower legs may be dry or shiny with poor toning or hair growth.

People with PVD may often have the same type of fatty buildup in the arteries supplying the heart, brain and kidney. This means that they are at high risk of stroke, heart disease and kidney failure. They are also more likely to be suffering from diabetes and high blood pressure.

"Lower le PVD is a disease that is often symptom less but becomes more severe over the time and without treatment can seriously impair a person's mobility and independence. Diabetes adds up further complications to this," says Dr Shailaja Kale, diabetologist.

Unfortunately, many people with the early symptoms of lower leg PVD, especially leg pain on walking, assume that this is just part of getting older and do not seek medical attention until they become severely debilitated.

"It is estimated that less than 30 per cent of PVD patients are diagnosed, mainly due to the fact that over 50 per cent are asymptomatic leg pain that may be present in only 10 per cent of patients. These patients at the end may land up suffering from gangrene of toe and foot, finally leading into amputation of limbs." says Dr Kamerkar.

Early diagnosis with a simple test called the ankle brachial index (ABI) test, Colour Doppler and CT Angiography offers the possibility of dramatically improving the lives of the millions of lower leg PVD patients. Appropriate treatment can be started to relieve symptoms and stop progression of the disease and if necessary, referral to a specialist for further investigations or treatment.