vascular insufficiency, inadequate peripheral blood flow. Causes include occlusion of vessels by atherosclerotic plaques, thrombi, or emboli; damaged, diseased, or intrinsically weak vascular walls; arteriovenous fistulas; hematologic hypercoagulability; and heavy smoking. Signs of vascular insufficiency include pale, cyanotic, or mottled skin over the affected area; swelling of an extremity; absent or reduced tactile sensation; tingling; diminished sense of temperature; muscle pain, such as intermittent claudication in the calf; and, in advanced disease, ulcers and atrophy of muscles in the involved extremity. Diagnosis may be made by comparing peripheral pulses in contralateral extremities or by angiography, plethysmography, ultrasonography, and skin temperature tests. Treatment of vascular insufficiency may include a diet low in saturated fats, moderate exercise, sleeping on a firm mattress, avoidance of tobacco products, proper standing or sitting posture, elevation of the involved extremity, use of a vasodilating drug, and, if indicated, repair of an arteriovenous fistula or aneurysm or bypass surgery. See also arterial insufficiency.
