What Is Vascular Disease?

The vascular system is the network of blood vessels that circulate blood to and from the heart and lungs. Vascular diseases are very common, especially as people age. Unfortunately, vascular disease is often “silent” in the early stages, causing few symptoms. Untreated, however, vascular disease can cause a host of problems, from varicose veins and phlebitis to life threatening complications such as stroke and pulmonary embolism.

There are two types of vascular disease: venous and arterial. Common arterial problems occur when arteriosclerosis, blood clots and other vascular conditions occur in the arteries. Common venous problems include varicose veins and deep vein thrombosis, which can lead to pulmonary embolism.

Some vascular problems can affect either type of vessel, such as aneurysms and arteriovenous malformations (AVMs), abnormalities in which the blood vessels are tangled and distended. Aneurysms and AVMs are generally “silent” until they rupture.

Diagnosing Vascular Disease

Several medical specialties are involved in the diagnosis and treatment of vascular disease. At Portsmouth Regional Hospital, our medical staff offers a full range of vascular services, enhanced by the latest treatment technologies.

Your primary care physician is on the “front line” of vascular care. He or she is often the first to identify the risk factors and warning signs of vascular disease, which are many of the same risk factors associated with heart disease: high blood pressure, high cholesterol, family history, smoking and obesity.

As your doctor will tell you, the best way to prevent vascular disease is to live a “heart healthy” lifestyle. Don’t smoke; eat nutritious, low fat foods; exercise; control risk factors and maintain a healthy weight.

If your doctor suspects that you have vascular disease, you will probably be referred to our Radiology Department for a diagnostic test. Ultrasound, CT scans, angiography, MRI and nuclear medicine are some of the diagnostic tests our radiologists use for diagnosing vascular disease.

Vascular Surgery

Should your vascular problem require further intervention, your doctor may refer you to one of our many physicians who perform vascular surgery. In addition to our top-notch general surgeons, Portsmouth Regional Hospital’s medical staff also includes a team that specializes in cardiothoracic and vascular surgery. Because there are so many types of vascular disease treatments, it’s important to consult with your primary care physician to ensure that you choose the physician best qualified to treat your particular condition.

There are many highly successful surgical procedures that can help improve circulation, remove blockages and repair damaged blood vessels.

Minimally invasive varicose vein treatment is a new option for many patients with varicose veins. Until recently, treating varicose veins involved surgically disconnecting the affected vein, and actually removing it in a process called vein stripping. At Portsmouth Regional Hospital, we now use an ultrasound-guided technology that uses an electrical current to shrink the vein in place.

Endarterectomy is the general term for the surgical removal of plaque from an artery that has become narrowed or blocked. Our vascular surgeons use endarterectomy to treat many arteries; however, the most common use is for carotid arteries, the arteries in your neck that deliver blood to the brain. Treatment of carotid blockages (also called “stenosis”) has been shown to significantly reduce the occurrence of stroke and TIA (sometimes called “mini” strokes). Our surgeons also perform endarterectomies to clear blockages in the arms, legs, aorta, kidneys and other organs.

Angioplasty is also used to improve circulation and remove blockages. In an angioplasty, the vascular surgeon inflates a small balloon inside a narrowed blood vessel. Depending upon the circumstances, a tiny mesh tube called a stent may be placed in the artery to support the artery walls and keep the vessel open.

Aneurysm repair is a common vascular surgery procedure. An aneurysm (an enlarged and weakened section of an artery) is a serious health problem, because it can rupture as it increases in size. Besides rupturing, blood clots can form in an aneurysm and block blood flow to parts of the body.

Most aneurysms occur in the aorta, the artery that runs from your heart through your chest and abdomen. The most common type of aneurysm is an abdominal aortic aneurysm. An aneurysm in your chest is called a thoracic aortic aneurysm. Aneurysms also occur in the head, neck, thigh, knee, spleen, liver, kidneys, or stomach.

Surgical bypass is not only used to treat damaged arteries in the heart; it can also be used create a bypass around blocked arteries in the arms and legs.

Warning Signs of Vascular Disease

Although often “silent,” vascular disease can lead to serious health problems, such as tissue death and gangrene requiring amputation or other surgery; chronic disability and pain; and weakened blood vessels that may rupture without warning. There can also be deadly complications such as stroke or pulmonary embolism (a blood clot that travels to the heart and lungs).

Vein Disease symptoms:

There may be no symptoms of venous disease caused by blood clots until the clot grows large enough to block the flow of blood through the vein. Symptoms may then come on suddenly and include sudden swelling or enlargement, pain, warm and discolored skin in the affected limb.

Pulmonary Embolism symptoms:

Many of these symptoms are similar to those of heart attack:

• a sudden feeling of apprehension
• shortness of breath
• sharp chest pain
• rapid pulse
• sweating
• cough with bloody sputum
• fainting

Symptoms of Varicose Veins

Most varicose veins have no symptoms other than the appearance of purplish, knotted veins on the surface of the skin. A physician should be consulted and treatment may be required if there is:

• pain or heaviness in the leg, feet and ankles
• swelling
• sores or ulcers on the skin, or
• severe bleeding if the vein is injured

Risk Factors for Vascular Disease

The following factors increase the chances of vascular disease. As with other cardiovascular disease, you can lower your risk with a healthy diet and exercise.

• a family history
• increasing age that results in a loss of elasticity in the veins and their valves
• pregnancy
• illness or injury
• prolonged periods of inactivity - sitting, standing or bed rest hypertension, diabetes, high cholesterol or other conditions that affect the health of the cardiovascular system
• smoking
• obesity