March 18

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What Causes Vascular Disease in the Legs?

By Dr. Jose Almeida

March 18, 2020


​Vascular disease can affect either veins or arteries. Despite both veins and arteries being part of the vascular system, the disease that affects these vessels and the symptoms they cause are different, since veins and arteries have different functions. Disease of the veins is seen more commonly and affects more people than artery disease. 

"​​Both artery and venous disease can be of concern, but venous disease is much more common in the legs." - Dr. Almeida 

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​What Causes Atherosclerosis?

The most well known disease of the arteries is atherosclerosis, which is the known culprit for heart attacks and strokes. Atherosclerosis can affect other arteries, especially those in the legs, which is called peripheral arterial disease or peripheral vascular disease.

Symptoms of peripheral arterial disease are:

  • pain in the legs that worsens with activity and improve with rest
  • non healing wounds from small trauma to the skin
  • hair loss
  • coolness of the leg
  • pale skin tone
  • reduced pulses in the legs

All of these symptoms are caused from blood not getting to the legs appropriately from blockages in the arteries.

Atherosclerosis or plaque build up and hardening in the arteries is the most common cause which is usually caused by high cholesterol, but may also be genetic. Obesity, diabetes, smoking, and high blood pressure are all associated with development of peripheral artery disease, as these conditions have an affect on the arteries, causing narrowing and preventing appropriate blood flow. 

leg artery disease illustration

Leg Artery Disease Diagram

Symptoms of Venous Insufficiency

​Disease of the veins in the legs leads to spider veins, varicose veins, deep vein thrombosis, and venous insufficiency. Spider veins may exist alone or with varicose veins. Varicose veins may exist alone or be a part of venous insufficiency. Deep vein thrombosis can be a complication of varicose veins and venous insufficiency.

  • Symptoms of spider veins are usually only cosmetic and are red or violaceous projections on the skin surface and do not cause any pain. 
  • Symptoms of varicose veins are swelling in the legs, heaviness, cramping, and twisted, enlarged veins. 
  • ​Symptoms of venous insufficiency may include the presence of varicose veins, pain, swelling, itchiness of the skin, and darkening of the color of the skin, particularly on the ankles.

Video: What Causes Spider Veins

Video: What Causes Varicose Veins

Causes of Vascular Disease in the Legs

Venous disease is caused by the malfunction of the valves within the veins, pooling of blood, and loss of elasticity of the veins. Veins are thin walled and do not contain muscles, therefore they rely on the one way valves and muscle contraction of the body to move blood against gravity and back toward the heart. If the veins no longer function, blood begins to pool, pushing the walls of the vein out and further preventing the valves to close.

Over time the veins remain stretched from the pooling of blood and are unable to return to their original structure. There are certain risk factors that may lead to the veins not functioning which are: 

  • static sitting or standing positions
  • obesity
  • pregnancy
  • age
  • family history
  • prior vein trauma

Deep vein thrombosis can be a result of the pooling of blood, as the blood may begin to clot. Symptoms of deep vein thrombosis are significant pain, swelling, and redness of the skin. Additional risks for developing deep vein thrombosis are smoking, pregnancy, hormone replacement, obesity, and static positions.

Video: Causes of Lymphedema Venous Disease

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How To Prevent Artery and Venous Disease

Both artery and venous disease can be of concern, but venous disease is much more common in the legs. There are different risks for the development of either artery or venous disease, but there may be some overlap. Some risks can be modified, while others cannot. The best way to try and prevent vascular disease is a healthy diet, management of weight, and regular cardiovascular exercise. If you have concerns for vascular disease visit with a board certified vascular surgeon to learn more about ways that these diseases may be treated. 

Video: 5 Ways to Prevent or Delay Venous Disease

Dr. Jose Almeida

About the author

Dr. Jose Almeida, MD, FACS, RPVI, RVT is a veteran academic vascular surgeon who practices Endovascular Venous Surgery in Miami, FL. He is also a Diplomate of the American Board of Surgery in both Vascular Surgery and General Surgery.

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