As a vascular surgeon, I encounter a wide spectrum of vascular disorders which affect the intricate network of blood vessels and lymphatic systems throughout the body.
Blood flows smoothly in the body, transporting oxygen, and nutrients via arteries to tissues. Veins return blood to the heart and lungs to exchange carbon dioxide and metabolic waste. Damage or disease in blood vessels disrupt this flow, causing issues from mild spider veins, or varicose veins to severe complications like gangrene, bleeding, limb loss, or strokes.
Many are unaware of treatable conditions causing delayed treatment for leg pain, often resulting in irreversible damage like gangrene. About 85% of all lower limb amputations in diabetics are preceded by foot ulcers, when detected early, can save a leg.
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Here are a few common vascular disorders
1. Atherosclerosis: This common condition involves the build-up of plaque (fatty deposits) inside arteries, which can restrict blood flow. Atherosclerosis can affect arteries in the heart (coronary arteries), brain (carotid arteries), arms, legs, and elsewhere in the body.
2. Peripheral Artery Disease (PAD): PAD refers to narrowing of the arteries that supply blood to the extremities, particularly the legs. It often leads to leg pain while walking (claudication) and increases the risk of serious cardiovascular events.
3. Aneurysms: An aneurysm is a weakened and bulging area in the artery wall, which can rupture and cause life-threatening bleeding. They commonly occur in the aorta (the largest artery in the body) and in the brain (cerebral aneurysms).
4. Varicose Veins: These enlarged, twisted veins usually appear in the legs and can cause discomfort or pain. While often a cosmetic concern, they can sometimes lead to more serious issues like skin ulcers or blood clots. People in jobs that require long hours of standing such as police, chefs, bus conductors, teachers, etc have a tendency to develop varicose veins -- characterized by swollen legs, heaviness in calf muscles, discoloration of ankles, and itchy skin.
5. Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): DVT is the formation of blood clots in the deep veins, typically in the legs. If a clot breaks loose and travels to the lungs, it can cause a pulmonary embolism, a potentially fatal condition.
6. Diabetic Foot: Diabetic foot refers to foot problems like wounds in patients with diabetes mellitus, including neuropathy (nerve damage), poor circulation, and susceptibility to infections. It can lead to foot ulcers and, in severe cases, amputation. While walking and age-appropriate exercises are good for controlling diabetes and blood pressure, those with long-standing diabetes are prone to developing arterial blocks and should take care of their feet and avoid walking barefoot.
7. AV Fistula for Dialysis Patients: An arteriovenous (AV) fistula is a surgically created connection between an artery and a vein, commonly used in dialysis patients to facilitate the efficient removal and return of blood during dialysis.
Diagnosis
Accurate diagnosis of vascular disorders is crucial for effective treatment. This often involves:
* Physical Examination: Assessing symptoms such as pain, swelling, pulsations or ulcers.
* Imaging Tests: Doppler ultrasound, CT angiography, MRI, and angiogram help visualize blood flow and detect blockages or abnormalities.
* Blood Tests: These can indicate clotting disorders or biomarkers related to vascular inflammation.
Treatment Options
Treatment depends on the specific disorder and its severity in the patient:
* Medications: Blood thinners, cholesterol-lowering drugs, flavonoids, and medications to control blood pressure, and diabetes are commonly prescribed.
* Minimally Invasive Procedures: Angioplasty, stenting, and thrombectomy can restore blood flow in narrowed or blocked arteries. Laser, radiofrequency ablation, and endovenous glue are being used extensively in various stages of varicose veins.
* Surgery: For complex cases like aneurysms or severe PAD, surgical intervention may be necessary to repair or bypass affected blood vessels.
* AV Fistula Creation: Regular monitoring and care to ensure the AV fistula remains healthy and functional for dialysis patients.
Early diagnosis & appropriate treatment are essential for managing vascular disorders and reducing the risk of complications.
Empowering lifestyle changes, vascular health awareness, early detection, and prompt treatment can enhance life quality, safeguard limbs, and prevent amputations.