South Carolina ranks highly in many prestigious categories, but unfortunately it also ranks higher than the national average for rates of a host of health concerns such as smoking, diabetes and cardiovascular disease. These health concerns happen to also be risk factors for a debilitating condition called peripheral vascular disease; the high rate of these health risk factors elevates the rate of PVD in South Carolina.
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“Basically, PVD is a buildup of plaque material within the arterial system in which blockages can develop. These blockages limit blood supply to the legs and feet,” explained Randall Franz, M.D., a vascular surgeon with Coastal Vascular & Vein Center. If left untreated, the condition can lead to severe pain, gangrene, limb amputation or critical limb ischemia, which is life- and limb-threatening.
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Patients at risk for PVD tend to have a history of smoking, high cholesterol, high blood pressure or diabetes or be general- ly inactive.
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“Symptoms for PVD begin as claudication. Someone may feel pain or discomfort in the legs during activity – even while walking just short distances – and the pain is relieved by resting the legs,” Dr. Franz said. “Eventually, the condition will progress to the point that the pain is no longer relieved with rest, which is known as ischemic rest pain – the arteries are narrowed; blood flow to the legs is hindered. This chronic pain can feel like someone has tied a tourniquet on the leg.”
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Even more progressed symptoms show at the third stage of PVD and are red flags that the disease could lead to limb loss
or even loss of life. Coldness in the limb, sores, ulcers, dry skin, thickened toenails, a diminished or absent pulse and wounds on the leg that do not heal can be signs of limb ischemia.
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Treatments for PVD range from medicine to endovascular procedures and eventually to bypass treatments if the condition is extreme.
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“Medicinal treatments are the first step,” Dr. Franz explained. “Certain medications can improve blood flow, and we use vascular testing to check a patient’s blood supply and see what degree of blockages that they have. If a patient has wounds and blockages despite the maximum medicinal treatments, the next step is an angiogram and endovascular treatment to improve blood supply to the legs and feet. As a last resort, bypass surgery is an option to save the limb or the patient’s life.”
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CVVC’s skilled endovascular techniques are completed as an outpatient procedure and can be performed in-office, at its surgery center or its office-based lab, depending on the individual patient’s needs.
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Endovascular treatment with CVVC’s vascular surgeons usually entails puncturing an artery in the groin, through which doctors can take pictures of the blockages and open them using a variety of techniques, depending on each patient’s needs. One option is an atherectomy, which is a minimally invasive laser treatment. Another way to treat PVD is with an angioplasty – a balloon inserted and inflated to open narrow or blocked arteries. Metallic tubes called stents also are used to keep passageways open long-term.
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Because of the level of skill and technology available at CVVC, recovery from these procedures is simple by design. Patients usually spend about a half-hour or so recovering in the office and then finish recovering at home with some moderate walking and encouragement to take it easy for a few days before resuming regular activity. “One of the great benefits of being able to do these procedures as outpatient, rather than in a hospital setting, is that patients can heal better – they tend to move more and benefit from being with their friends or family, rather than recovering in a hospital,” Dr. Franz added.
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“Our goal and motto at Coastal Vascular & Vein Center
is ‘Saving Lives, Saving Limbs,’” he said. “We specialize in conditions like PVD and have skilled doctors, procedures and technologies unique to the Charleston and Lowcountry area to help our patients overcome these health issues.”
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Dr. Franz spent over 20 years as a chief vascular surgeon in other states before coming to Charleston to work at CVVC be- cause of its cutting-edge treatments. For example, CVVC’s vascular surgeons have the ability to treat complicated areas that are not commonly able to be treated in this part of the country.
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“That’s our ultimate goal – saving lives and limbs,” Dr. Franz said. “We have the skill-set and ability to provide the best treatment options in the region to our patients and improve their quality of life.”
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“When we treat the lower extremities, we can treat from in- side the patient’s abdomen, where the arteries start, and go all the way down into the foot, which is unique for the Charleston area,” Dr. Franz explained. “Treating within the foot is complex and difficult, but, if you want the best option to salvage limbs, that’s what you have to do. It’s unique to Coastal Vein & Vascular Center.”
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If you or a loved one are experiencing symptoms of peripheral vascular disease, it is important to seek medical treatment early on. Treating the disease with medicine or minimally invasive treatments are ideal and easy ways to overcome further health complications, though bypass surgery can be completed in an effort to save a patient’s limb or life.

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