Peripheral Vascular Disease


Peripheral vascular disease is a nearly pandemic condition that manifests as insufficient tissue perfusion. It is initiated by existing atherosclerosis usually compounded by either an emboli or thrombi.

Peripheral Vascular Disease

The process of atherosclerosis is discussed in the cardiac section of this website. It is the gradual progressive occlusion of the medium and large arteries. There is initially, as described in the cardiac section, endothelial dysfunction with loss of arterial elasticity. There is also inflammation, as well as free radical damage secondary to an initial insult. This insult may be infections, heavy metals, toxic, or related to the lipid particle size which has been discussed in great detail elsewhere on this site.

I perform a battery of blood and urine tests that look at markers of atherosclerosis. The involve testing like CRP, homocysteine, fibrinogen, LPa, and lipid particle size and other tests.

Endothelial function is also assessed, as well as the elasticity of the arteries.


If you are walking or climbing up the hill and you suddenly notice a dull cramping pain in your leg you may have peripheral vascular disease. Intermittent claudication is leg discomfort typically in the middle of your calf that occurs with exercise or during exertion and is usually relieved by rest. There may also be pain in the extremity with discoloration. The risk factors include smoking, high cholesterol, high triglycerides, diabetes, and hyperviscosity, as well as inflammation and free radicals.


Ankle-brachial index is performed, as well as non invasive imagining using Doppler ultrasound is done. The pressure at the brachial artery and at the posterior tibial artery is measured. The ankle cephalic pressure is divided by the brachial pressure, both measured in a supine position. Normally, the ratio is more than 1. In severe disease it is less than 0.5.

With MRI the plaques are usually seen as the difference between vessel wall and flowing blood. MRI also has the benefits of angiography to provide even higher detail and can replace traditional arteriography.


In an acute event early surgical consultation is warranted. Depending on the case the treatment may be either interventional radiology or proceed directly to the operating room. Aortofemoral bypass might be performed or percutaneous transluminal coronary angioplasty (PTCA) is done. Medication is also used.


The standard treatment for PVD typically includes lifestyle changes such as stop smoking, getting regular exercise, and eating a healthy diet.

There are some FDA approved drugs for PVD and in severe cases surgery is warranted.

Peripheral vascular disease is secondary to widespread atherosclerosis. The underling pathology is endothelial dysfunction of the arterial wall. This can be easily measured even in the early stages and preventive therapies instituted.

The pain noted in the calves on exertion is secondary to low arterial flow and low oxygen levels.


I am currently performing ozone under an IRB study which improves oxygenation dramatically, as well as endothelial dysfunction.

I do appropriate cardiac testing to evaluate free radicals, inflammation, toxin, heavy metals, and infections, as well as hormone levels.

It has been shown that many therapies to improve vascular dilation by nitric oxide actually do work.

I am currently using a product with arginine, as well as beets which clinically raises nitric oxide and has been cleared for peripheral vascular disease. It is an FDA cleared medical food.

Other beneficial alternatives include ginkgo, pomegranate, carnitine, alpha lipoic acid, niacin, as well as natural hormone replacement which also raise nitric oxide.

In addition to this, I feel that the removal of heavy metals with chelation would be important because heavy metals decrease nitric oxide.

My treatment is involved with increasing blood flow, as well as raising the oxygen levels. If there is an inflammatory component this is addressed.

Dr. Silver performs extensive testing to look at your mitochondrial function, free radicals, infections, and other causing factors of atherosclerosis.

If the above therapies are not effective or you have already had surgery and it has failed then you are dealing with critical limb ischemia, and stem cells may help you.

Dr. Silver’s other therapies include intravenous therapies, iv ozone, pulsed electromagnetic therapy (PEMF), photon therapy, hyperbaric oxygen therapy, and far infrared therapy. He is also using microcurrent therapy.