Peripheral Vascular Disease

Case Studies 

A 52-year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except for decreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibial pulses were markedly decreased compared with those of his left leg.

Studies Results 

Routine laboratory work Within normal limits (WNL)

Doppler ultrasound systolic pressures Femoral: 130 mm Hg; popliteal: 90 mm Hg; posterior tibial: 88 mm Hg; dorsalis pedis: 88 mm Hg (normal: same as brachial systolic blood pressure)

Arterial plethysmography Decreased amplitude of distal femoral, popliteal, dorsalis pedis, and posterior tibial pulse waves

Femoral arteriography of right leg Obstruction of the femoral artery at the midthigh level

Arterial duplex scan Apparent arterial obstruction in the superficial femoral artery

 Diagnostic Analysis 

With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography to document the location of the vascular occlusion. The patient underwent a bypass from the proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.

Critical Thinking Questions 

1. What was the cause of this patient’s pain and cramping?

2. Why was there decreased hair on the patient’s right leg?

3. What would be the strategic physical assessments after surgery to determine the adequacy of the patient’s circulation?

4. What would be the treatment of intermittent Claudication for non-occlusion?




Case Study Lyme Disease and Peripheral Vascular Disease




Student’s Name






Case Study Lyme Disease and Peripheral Vascular Disease

Peripheral Vascular Disease

“you do not have to be great to make the first step. But you must make the first step in order to become great.” (Corpus Aesthetics). Peripheral vascular disease is an infirmity affecting the blood vessels outside the heart and brain, specifically those in the legs and feet (Min et al., 2021). It is brought about by the formation of fatty materials in the arteries causing them to narrow and become less flexible. This minimizes blood flow to the pretentious areas causing pain, cramping, and other symptoms. It can also amplify the risk of developing blood clots, causing more server complications like a heart attack or stroke. Treatments for peripheral vascular disease entail lifestyle changes like stopping smoking, regular exercising and having a healthy diet and medications to manage symptoms preventing complications. Surgery may be appropriate in more severe cases to restore normal blood flow to the pretentious areas. This essay will explore a case study of a 52-year-old man complaining of pain and cramping in his right calf caused by walking two blocks. From the case study, the essay will explain the cause of the patient’s pain and cramping, why there was decreased hair on the patient’s right leg, the strategic physical assessments after surgery to determine the adequacy of the patient’s circulation, and the intermittent treating claudication for non-occlusion.

The Cause of the Patient’s Pain and Cramping

The patient’s pain and cramping were generated by a depletion in blood flow to his right leg, mainly because of an arterial blockage in the peripheral femoral artery. This blockage hinders adequate blood supply to the muscles in his right calf, causing pain and cramping during physical activity. The case study indicated that there was decreased hair on his right leg and also reduced pulses in his popliteal, dorsalis pedis, and posterior tibial arteries, highlighting the necessity for the diagnosis of peripheral artery disease (Beckman & Creager, 2019). The patient also indicated symptoms of classic intermittent claudication, distinguished by pain during physical activity relieved with rest, habitual of peripheral artery disease. The effective detour surgery from the proximal femoral artery to the popliteal artery repaired blood flow to the pretentious area, leading to the resolution of symptoms.

Reasons why there was Decreased Hair on the Patient’s Right Leg

The reduced hair on the patient’s right leg signals poor blood flow to the leg, likely caused by the arterial blockage in the proximal femoral artery. The blood provision to the legs is crucial for the sustenance of the hair follicles, and the lack of blood flow can lead to reduced hair growth and, to some extent, hair loss (Conta et al., 2021). The condition is termed ischemic alopecia, a. It is mainly seen in patients with peripheral arterial disease or any other kind of vascular disorder. Hence, the reduced hair on the patient’s right leg is a physical manifestation of the basal arterial blockage and faulty blood flow to the legs. It is essential to consider factors that can enable an individual to overcome peripheral arterial disease to avoid such circumstances as that of the patient in the case study.

Strategic Physical Assessments After Surgery to Determine the Adequacy of the Patient’s Circulation

After the patient undertakes detour surgery for the arterial blockage in the proximal femoral artery, it is essential to carry out strategic physical assessments to decide the adequacy of the patient’s circulation. Such assessments may involve monitoring the patient’s pulse and blood pressure in the pretentious leg and comparing them to the other leg (Maiolino et al., 2021). The patient’s skin color, temperature, and capillary refill time in the pretentious leg have to be assessed. Additionally, the patient may require to carry out exercise testing to assess the prosperity of the detour surgery in enhancing blood flow and relieving symptoms of sporadic lameness. To evaluate the detour graft, ensuring that blood flows to the pretentious leg is enough, it would be essential to perform follow-up imaging studies like Doppler ultrasound and arteriography (Rother et al., 2018). By carrying out such strategic physical assessments, healthcare providers can observe the patient’s progress and adjust their treatment plan appropriately, ensuring the best viable outcomes.

The Treatment of Intermittent Claudication for Non-occlusion

The treatment of intermittent claudication that is not a result of arterial blockage entails lifestyle modification and medication targeted to minimize risk factors for atherosclerosis, the underlying principle of the condition. It includes smoking termination, exercising regularly, and eating a healthy diet, as well as controlling high blood pressure, diabetes, and hyperlipidemia. According to Das et al. (2019), medications like antiplatelet agents, cilostazol, and statins can also be directed to enhance blood flow and minimize symptoms. Additionally, administered exercise programs and rehabilitation can be appropriate to enhance walking distance and overall physical function.


Peripheral vascular disease is a medical circumstance causing leg pain and discomfort and from the case study of a 52-year-old man with classic symptoms of intermittent claudication caused by an arterial blockage in the proximal femoral artery. Noninvasive Doppler and plethysmography arterial vascular study and femoral arteriography determined the diagnosis. The patient had a prosperous detour surgery where the symptoms reduced. Strategic physical assessments after surgery can regulate the adequacy of the patient’s circulation. Treatment for intermittent claudication hangs on the underlying source, including lifestyle modification, medication, and surgery. Diagnosing and treating peripheral vascular disease on time can proscribe further complications enhancing the patient’s quality of life.


















Beckman, J. A., & Creager, M. A. (2019). Peripheral artery disease: Clinical evaluation. Vascular Medicine: A Companion to Braunwald’s Heart Disease E-Book, 239.

Conta, G., Libanori, A., Tat, T., Chen, G., & Chen, J. (2021). Triboelectric nanogenerators for therapeutic electrical stimulation. Advanced Materials33(26), 2007502.

Das, A. S., Regenhardt, R. W., Feske, S. K., & Gurol, M. E. (2019). Treatment approaches to lacunar stroke. Journal of Stroke and Cerebrovascular Diseases28(8), 2055-2078.

Maiolino, G., Bisogni, V., Soranna, D., Pengo, M. F., Pucci, G., Vettor, R., … & Silvani, A. (2021). Effects of insomnia and restless legs syndrome on sleep arterial blood pressure: a systematic review and meta-analysis. Sleep Medicine Reviews59, 101497.

Min, J. Y., Choi, Y. S., Lee, H. S., Lee, S., & Min, K. B. (2021). Increased cold injuries and the effect of body mass index in patients with peripheral vascular disease. BMC Public Health21(1), 1-10.

Rother, U., Lang, W., Horch, R. E., Ludolph, I., Meyer, A., Gefeller, O., & Regus, S. (2018). Pilot assessment of the angiosome concept by intra-operative fluorescence angiography after tibial bypass surgery. European Journal of Vascular and Endovascular Surgery55(2), 215-221.