Understanding Vascular Disease
Vascular disease affects the arteries and veins that carry blood throughout the body. Estimates are that anywhere between 8 and 15 million Americans have vascular disease; at least half have no symptoms.
Vascular disease is serious – it can reduce life expectancy by causing heart attack, stroke, ruptured blood vessels and kidney failure.
There are many conditions that can affect the circulatory system, but the most common is atherosclerosis, which is the buildup of plaque – fatty deposits of cholesterol and calcium – in the walls of the blood vessels. As these deposits grow, they can restrict the flow of blood to muscles, organs and tissues. This process occurs over a period of years.
Another type of vascular disease is called vasculitis. This occurs when blood vessels become swollen and painful.
When the walls of the blood vessels become thin, they bulge and may rupture. This is called an aneurysm.
The risk factors for vascular disease are the same as heart disease. Risk factors that can be changed include:
- High cholesterol
- High blood pressure
- Being overweight
- Sedentary lifestyle
Risk factors that cannot be changed include age (over 50), post menopause, or having a family history of vascular disease.
Peripheral Artery Disease (PAD)
PAD is a common circulatory problem in which the arteries that supply blood to your limbs become clogged or partially blocked. When this happens, your extremities receive less blood than they need to work properly and remain healthy.
Although PAD can occur in either the arms or the legs, the term PAD is typically used to describe blockages in the legs.
When the blood supply to leg muscles is decreased, it causes severe cramping, called claudication. Sufferers are only able to walk a certain distance before the cramping becomes so painful they must stop and rest. Although rest relieves the pain, it returns again once exercise resumes.
The pain occurs during exercise because the blood vessels are unable to meet the muscles’ need for increased oxygen and energy.
Untreated PAD is a crippling disease. A complete blockage can result in leg ulcers that don't heal, leg pain while at rest, or even gangrene and possible amputation.
The presence of PAD may also indicate blockages in the vessels elsewhere in your body, including your heart or brain.
Carotid Artery Disease
You have two carotid arteries – one on either side of your neck – that extend from your aorta in your chest to the brain inside your skull. Just like other parts of your circulatory system, these arteries can become blocked by the buildup of fatty deposits, called atherosclerosis.
There are several ways atherosclerosis in the carotids can cause stroke.
First, the plaque can block blood flow to the brain entirely.
Secondly, a piece of plaque can break off from the deposit and travel through your bloodstream to the brain. This particle can lodge in a smaller artery in the brain and cause a stroke by blocking blood supply in that area.
Finally blood clots can form around plaque deposits in the carotid arteries, break loose and travel to the brain. If the clot blocks the artery enough to slow or stop blood and oxygen flow to your brain, it could cause a stroke or blindness. .
You are more likely to develop carotid artery disease as you age. Only 1 percent of adults age 50 to 59 have significantly narrowed carotid arteries, but 10 percent of adults age 80 to 89 have this problem.
You may be able to prevent or slow carotid artery disease. Stopping tobacco use is the most important change you can make to avoid this disease. Other ways to prevent carotid artery disease include:
- Exercising regularly
- Eating a healthy diet
- Maintaining a healthy weight
It is also important to control diabetes, high blood pressure and cholesterol levels to reduce your risk of developing carotid artery disease.
Treating Carotid Artery Disease
Treatment depends on the severity of the disease, symptoms and overall health. As a first step, your vascular surgeon may recommend medications and lifestyle changes.
You may require surgery if your carotid artery disease is severe or has progressed. Signs of severe disease include having TIA symptoms, having experienced a stroke in the past, or just having a severely narrowed carotid artery even without symptoms.
During surgery, the vascular surgeon removes the plaque that is blocking your carotid artery. The procedure is called carotid endarterectomy and can be performed using a local or general anesthetic, depending upon the particular situation. Once the anesthesia has taken effect, the vascular surgeon makes an incision in your neck and then removes the plaque contained in the inner lining of your carotid artery. You may even be able to leave the hospital as early as the same day or the day after the procedure depending upon how you feel.
A newly developed minimally invasive procedure to treat carotid artery disease is angioplasty and stenting. This is usually performed using a local anesthetic.
The vascular surgeon may insert a long, thin tube through a small puncture site, guide it through your blood vessels to your carotid artery. The catheter carries a tiny balloon that inflates and deflates, flattening the plaque against the walls of the artery. After the plaque has been compressed the surgeon will place a tiny metal-mesh tube called a stent in the artery to hold it open.
Aortic aneurysms are a swelling or ballooning of the aorta wall where it has been thinned and weakened from atherosclerosis. The aorta is the body's largest blood vessel and carries blood directly from the heart down through the chest and abdomen for distribution throughout the rest of the body. An aneurysm can be located in the chest (thoracic aortic aneurysm – TAA) or abdomen (abdominal aortic aneurysm – AAA) and often grows over a period of years. If untreated, an aneurysm will eventually rupture, which is usually fatal.
Aneurysms are treated surgically. A patch or artificial piece of blood vessel is sewn where the aneurysm was.