What You Need to Know About Vascular Disease

Vascular disorders affect millions of people. Some cause cosmetic problem. Others can cause leg pain, leg swelling and other symptoms. Certain vascular conditions can increase risk for stroke, limb loss, or even death.
This column will briefly describe some common vascular conditions affecting women today.
Varicose veins and venous insufficiency
Over 20 million Americans are affected by varicose veins and their underlying cause, venous insufficiency. Varicose veins are more than just a cosmetic problem. The most common symptoms are leg pain, leg swelling, leg fatigue, itching and the appearance of protruding legs veins or spider veins.
In more advanced cases, changes to the appearance and integrity of the skin and leg ulcers can occur. The most common risk factors are a family history of varicose veins, occupations that require standing, being over weight and pregnancy. Some people may not have any of these risks. Varicose veins are most commonly caused by a defect in the vein valves, called venous insufficiency or venous reflux.
This allows blood to pool in the legs, leading to the appearance and symptoms of varicose veins.
Modern techniques now allow for successful treatment of varicose veins and venous insufficiency with minimally invasive procedures. A vascular surgeon can often cure venous insufficiency with a 15-30 minute office procedure, without the need for painful surgery or hospitalization.
Peripheral Artery Disease (PAD)
Peripheral Artery disease (PAD) can also cause leg pain. However, it is a much different problem from venous insufficiency, described above. Venous insufficiency affects veins, which carry blood back to the heart. PAD affects arteries, which carry oxygenated blood to the tissues and organs of the body.
PAD most commonly affects people over age 50. The lining of our arteries is normally very smooth, which allows for the unobstructed passage of blood. In PAD, plaque buildup in the arteries causes this surface to become irregular and narrow, which restricts blood flow.
PAD can cause pain in the legs when walking, known as intermittent claudication. In severe cases, it can lead to risk of amputation and can be an indicator of the presence of heart disease. Sometimes it is completely silent. The most common risk factors are smoking, diabetes, high blood pressure, and high cholesterol.
The diagnosis can usually be made with physical examination and noninvasive Doppler testing. Treatment depends on the severity and often involves medications and reducing risk factors. If procedures are necessary, minimally invasive techniques, such as angioplasty and stents may be used. In some cases, traditional surgical procedures are required to treat PAD.
Carotid Artery Stenosis
The carotid arteries provide oxygen rich blood to the brain. They can become narrowed by plaque, causing the obstruction of blood flow to the brain, known as carotid artery stenosis. Since the carotid arteries provide the main blood flow to the brain, when they become narrowed, there can be an increased risk of stroke. Small pieces of plaque can break off from the carotid arteries and lodge in the tiny arteries of the brain, interrupting blood flow to sections of the brain.
In some cases, the entire carotid artery can become blocked, potentially causing the interruption of blood flow to a large area of he brain. Carotid artery stenosis may be completely silent until causing a stroke or until it is diagnosed on a physical examination. In some cases, there may be a warning sign, known as a mini stroke or TIA.
Carotid artery stenosis can usually be suspected on physical examination and confirmed with painless Doppler ultrasound testing. Treatment depends on severity. In many cases, treatment consists of medication, risk reduction, and close observation. In some cases, minimally invasive procedures, such as stents, or traditional surgery may be necessary to prevent stroke.
Abdominal Aortic Aneurysm (AAA)
The largest artery in the body is the abdominal aorta. When its walls become weakened, it can expand like a balloon, known as abdominal aortic aneurysm (AAA.) When AAA expands beyond its safe size, it may burst, known as ruptured AAA. This causes severe internal bleeding, shock and can be lethal.
AAA is most common in men over age 60, but also occurs in women. Risk factors include family history of AAA, smoking, high blood pressure and lung disease. AAA can be difficult to diagnose on physical examination because of the location of the aorta, deep in the abdomen. However, it is easily diagnosed with tests like ultrasound and CT scan. AAA is usually silent, but you might feel a pulsating sensation in the belly.
Severe abdominal or back pain may be an indication that AAA is unstable and at risk of rupturing. When AAA is small, surgery is usually not needed, but it is watched to be sure it does not enlarge. When AAA is larger, surgery may be needed to prevent rupture. Today, less invasive procedures can often be used than were previously needed.
This information is only meant to be a brief overview of general information about the conditions described. If you think you might be at risk for any of these conditions, it is recommended that you see your doctor or a vascular surgeon.
Jersey Shore Center for Vascular Health is the region’s premiere vascular and vein care center. Their Board Certified Vascular Surgeons have over 50 years combined experience in successfully treating thousands of individuals using the latest state-of-the-art techniques.
If you are experiencing the signs or symptoms of vascular disease or think you are at risk, the physicians of Jersey Shore Center for Vascular Health are available to help. Call (609) 927-VEIN (8346) for a consultation.