Peripheral vascular disease is not a sight for the faint-hearted, especially in the final stage. The signature darkening of the patient’s lower leg is followed by gangrene and the formation of ulcers, which often end with the limb being amputated.
From hindsight, it may appear that the problem is external. However, peripheral vascular disease is caused by the loss of blood flow due to the blocked blood vessels.
And the frightful knowledge to be derived from this disease is that clogged blood vessels are more common than people realise. This is especially true with Malaysians being spoiled for choice where diet is considered, not forgetting the poor lifestyle that many lead.
Speaking of lifestyle, smoking increases the formation of plaque in blood vessels. On the other hand, excessive blood sugar caused by diabetes makes the blood vessel brittle, exposing it to injury. These are several of the major factors contributing to peripheral vascular disease.
According to Institut Jantung Negara Consultant Cardiologist Datuk Dr Kumara Gurupparan, chest pains develop when said complication occurs in the vessels of the heart, and stroke is likely to happen if the vessel is linked to the brain.
Where peripheral vascular disease is concerned, the vessel towards the lower limb is being clogged, resulting in the lack of blood supply towards said region or in severe cases, the absence of blood.
During the early stage, the patient experiences pain in the buttocks, thighs and calf muscles after walking a short distance. The blood vessel may be blocked yet no major damage has occurred.
In the later stage, ulcers and wounds will develop on the leg and the patient may experience pain even during rest.
According to Kumara, the disease is very common among Malaysians since the population has a high prevalence of diabetes, comprising about 20 to 25% of the adult population. Smoking has also gone up.
“It can happen in any age group. It used to happen to people in their sixties and seventies, but now we are seeing those 40 to 50 years old coming in with peripheral vascular disease because there is an earlier onset of diabetes,” he said, adding that smoking among the young population has risen.
Kumara who has been working in IJN for the past 12 years sees an average of 35 patients per day and he said about 20% of those numbers suffer from peripheral vascular disease.
Towards treatment, Kumara said medication can be used to resolve the early stages of the disease by improving the patient’s walking distance.
Surgery is another alternative to resolve the later stage of peripheral vascular disease.
Diverging from these traditional approaches, Kumara brings a sophisticated form of treatment to treat the disease, known as peripheral intervention, a technique offered by few medical practitioners in the country.
“I spent one year in Italy, attached in a hospital to learn this technique, where we use wires, stents and balloons in the heart,” he said.
The same technology has been employed for the blood vessels in the leg.
The delivery involves making a small puncture to deliver said instruments to expand the clogged blood vessel.
Also, patients enjoy a shorter period of recovery, at around two to three days. With surgery, however, the length of hospitalisation may range from five to seven days.
Despite the cutting-edge technique that Kumara is able to perform, he is quick to point out that prevention is always better than cure.
According to him, it is vital for patients to go for regular checkups and to approach doctors at the earliest onset of symptoms.
Factors such as diabetes, high cholesterol and hypertension are major contributors to peripheral vascular disease and prevention involves treating these factors.
He advises diabetic patients to see a doctor every four to six months to check their blood sugar levels and ensure that they are optimised. As for hypertension, patients can monitor their blood pressure on their own.
He also warns against smoking and encourages a healthy lifestyle involving lots of physical exertion.