The condition is common, his approach is not.

James P. Zidar, MD, who directs the Duke Peripheral Vascular Disease Program at the Duke Raleigh Cardiovascular Center, talks about his team approach to care for peripheral vascular disease (PVD).

What is peripheral vascular disease?

PVD is a blockage in the vessels that supply blood to the organs and limbs. Millions of Americans have it, but many don’t realize it because they either miss the symptoms or mistake them for something else. It’s even more common in older people, with about 12 to 20 percent of the population having it by age 65.

James P. Zidar, MD

What would be worrisome about having PVD and not knowing it?

PVD can cause weakness or pain in your legs, making activity difficult. People often attribute these symptoms to something else or just ignore them, but PVD is a serious condition that left unchecked can lead to limb loss. PVD can also be an indicator of severe coronary disease, so early diagnosis can help prevent a heart attack.

How is it diagnosed?

Diagnostic tests include the quick and painless ankle-brachial index, x-ray angiography using contrast dye, ultrasound, and other tests. Ankle-brachial screening is recommended for everyone with diabetes over age 50.

So diabetes is a risk factor. Are there others?

Yes. In fact, the risk factors for PVD mirror those for heart disease: diabetes, tobacco use, high cholesterol and triglyceride levels, and high blood pressure. Prevention is the best medicine, and all these risk factors can be addressed.

What is your approach to treatment?

At Duke, we use a team approach, so we can determine the best course of care for each patient. We integrate conventional treatments such as angioplasty and stenting with minimally invasive, catheter-based treatments and some very sophisticated options like atherectomy, laser ablation, and cryoplasty. Plus, Duke’s PVD team is developing novel tests and treatments like gene therapy and stem-cell infusion.

Why do you hope people will read this?

Promoting awareness and increasing the diagnosis of PVD are top priorities of Duke’s Peripheral Vascular Disease Program. No matter how comprehensive our approach to treatment, it won’t help those who don’t pay attention to the symptoms and risk factors.

Duke Heart Center operates the world’s largest cardiovascular MRI program, the country’s top congestive heart failure program, the only program in the nation for advanced coronary artery disease, and the largest heart transplant, adult valvular disease, and congenital heart disease programs in the Southeast.