What people think of peripheral vascular (circulation) disease they usually think of PAD or peripheral arterial disease (Poor Circulation- Arterial Disease) because this is the type advertised on TV commonly. However, PAD is not the most common type of vascular disease (although it is the most serious type). Far more common is venous disease or venous insufficiency- more common by a margin of three to one. In this type of disease the lower part of the legs and sometimes the entire leg is completely swollen and discolored, and the skin becomes damaged from the increased pressure in the vein system. This leads to damage of the valves inside the veins, back flow of blood to the legs during the relaxation portion of the heart rhythm, and a leaking of fluid into the space between the tissues of the legs. The leakage can lead to a reddish brown discoloration and thin shiny appearance to the skin of the legs. The skin also becomes much more fragile, and can easily break down and form an ulceration (wound) that is often very difficult to heal. Varicose and spider veins can also be present and seen through the skin.
Causes of venous disease and swelling of the legs in general are many. Some of the causes include heart disease like congestive heart failure, medications such as those for high blood pressure, infections, clots, as well as surgery on the leg .
Treatments can range from medicine such as diuretics (water pills), compression garments or hosiery, and even surgery. In most cases there is no cure for damage to the veins, so life-long treatment is usually required. For some, weight loss can help and even surgery is not a definitive cure. Keeping the accumulation of fluid to a minimum can make the legs look and feel better and is the mainstay of treatment.