Vascular disease includes both problems with the arteries and the veins. The diseases that occur to arteries and veins are completely different and even have different causes. This is because veins and arteries have different functions.
The arteries have muscular walls and provide the body with oxygen, while the veins rely on valves and take blood back to the heart and lungs to dump waste and obtain more oxygen. Vascular surgeons are trained in both types of disease and treatments, however many vascular surgeons choose to focus either on arteries or veins alone.
"In cases where venous blockage occurs - usually after deep vein thrombosis (DVT)- procedures such as balloon angioplasty and venous stenting maybe be required to restore venous blood flow" - Dr. Almeida
1. Artery Disease
Atherosclerosis: narrowing of the arterial wall.
Disease of the arteries comes from narrowing of the arterial wall. Perhaps the most commonly known narrowing is atherosclerosis, which is a buildup of plaque within the arteries. With the arteries being narrowed, the blood is unable to flow appropriately to oxygenate tissue and with large blockages this can cause ischemia to tissues due to lack of blood flow. Ischemia can occur in any tissue, but strokes and heart attacks are well known conditions from ischemia.
Narrowing of the arteries is a direct result of several medical conditions, high cholesterol, high blood pressure, and diabetes, lifestyle factors such as weight, smoking, and eating habits, and lastly is also due to genetics. Disease of the arteries can be severe with permanent impairment from the loss of limbs and death.
2. Venous Disease
Clots blocking veins & weak vein valves inhibiting the body's ability to move blood back to the heart.
Disease of the veins can be attributed to veins being blocked by clots and from incompetent valves in the veins that make it difficult to push blood back towards the heart. Venous disease is less severe than disease of the arteries, however if a blood clot breaks free from the vein in the leg, this can move directly toward the lungs and cause a pulmonary embolism, which can be deadly.
Unlike disease of the arteries, there aren’t any specific medical conditions that cause venous disease. Venous disease is mainly caused by genetics. Other than genetics, certain lifestyle factors such as sedentary lifestyle and obesity can increase the risk. A history of a blood clot causes a cascade of inflammatory changes in the veins that can cause pooling of blood and this is referred to as post-thrombotic syndrome, which leads to venous disease.
Primary Causes of Vascular Disease
- Genetics
- Lifestyle (being inactive, overweight)
- History of Blood Clots
Treatment for Vascular Disease starts with Identifying the Cause
In order to treat vascular disease, it is important to understand the underlying cause. As arterial disease is commonly attributable to certain medical conditions, managing the medical conditions is the first priority.
Taking medications is of utmost importance to:
- reduce blood pressure
- reduce cholesterol
- manage diabetes .
In addition to taking routine medications, lifestyle changes can also help to manage medical conditions, such as:
- weight loss
- exercise
- smoking cessation
- reduction of high cholesterol and high sugar foods
Surgery for Vascular Disease Treatment
If it is too late to modify risk for arteriolar disease, surgery is an option with the use of stents, balloon dilation, or bypass surgery to widen narrowed areas to prevent ischemic events. For venous disease, genetics is a nonmodifiable risk, but daily exercise and maintaining an appropriate body weight may help to contribute to reduction in venous disease. Supplements, such as flavinoids or diasmin may increase the tone in veins, but more research is still necessary to determine their effectiveness. There are several surgical procedures to treat varicose veins, such as vein stripping, endovascular laser therapy, and sclerotherapy. These procedures can only address veins once they are varicose and there is not a specific treatment for prevention of varicose veins and venous disease.