Vascular Disease 101

Swelling, bulging or ballooning in the abdominal section of the aorta — the largest blood vessel in the human body that can rupture and become life-threatening. Abdominal aortic aneurysms most often do not have symptoms. They are best discovered through screening. See below to see if you qualify for aneurysm screening with an abdominal ultrasound.

One time screening ultrasound for Abdominal Aortic Aneurysm:

• All Men greater than 65 years of age
• All Women greater than 65 years of age with a history of smoking or cardiovascular disease
• All Men or Women greater than 55 years of age that have a first-degree relative of patients with abdominal aortic aneurysm

Abdominal aortic aneurysm, while serious, is treatable. Treatment is typically endovascular repair, in which a catheter is inserted through an artery in the leg to reach the aorta and site of the aneurysm. A metal mesh tube at the end of the catheter is placed at the site of the aneurysm, expanded and fastened in place to reinforce the weakened section of the vessel and prevent a rupture from occurring. Alternatively, in some cases, traditional open surgery is required. This is where an incision is made in the abdomen and the aneurysm is replaced with a plastic-type tube.

A progressive thickening of the lining of arteries that feed the legs with oxygen-rich blood driven by a buildup of plaque, a process that is known as atherosclerosis or “hardening arteries”. If left untreated, blood flow to the legs, feet, and toes is restricted, leading to possible tissue death and amputation. Some symptoms of PAD may include:

• A change in the colour of your legs
• Coldness in your lower leg or foot, especially when compared with the other side
• Erectile dysfunction in men
• Hair loss or slower hair growth on your legs and feet
• Leg numbness or weakness
• No pulse or a weak pulse in your legs or feet
• Painful cramping in one or both of your hips, thighs, or calf muscles after certain activities, such as walking or climbing stairs
• Pain when using your arms, such as aching and cramping when knitting, writing, or doing other manual tasks
• Shiny skin on your legs
• Slower growth of your toenails
• Sores on your toes, feet, or legs that won’t heal

If you are experiencing any of these symptoms, book an appointment with our vascular specialists.

Peripheral arterial disease, while serious, is treatable. Treatment is typically revascularization procedures to restore the flow of blood through arteries. There are two main revascularization procedures for PAD: angioplasty and an artery bypass graft. In an angioplasty, a blocked or narrowed part of an artery is widened by inflating a tiny balloon in the vessel and the addition of a stent which is a metal scaffold that holds the artery open. Whereas artery bypass takes vessels from elsewhere in the body and is used to bypass blood flow around the arterial blockage.

The development of atherosclerosis in the carotid arteries that supply your brain and head with oxygen-rich blood. Fatty plaques clog these arteries and increase the risk of stroke. This medical emergency can result in disability or death. There are no observable symptoms until a transient ischemic attack or stroke develops, in which case the following may occur:

• Sudden numbness or weakness in the face or limbs, often on only one side of the body
• Sudden trouble speaking and understanding
• Sudden trouble seeing in one or both eyes
• Sudden dizziness or loss of balance
• Sudden, severe headache with no known cause

If you are currently experiencing any of these symptoms, please call 911. If you have previously experienced any of these symptoms, book an appointment with our vascular specialists.

Carotid artery disease is commonly treated with a carotid endarterectomy where an incision is made along the front of the neck and plaque is removed from the carotid artery. The artery is then repaired with stitches or a graft.

Chronic Venous Insufficiency (CVI) occurs when the one-way valves in the veins of the legs that ensure blood return to the heart become faulty and cause blood to pool in the veins of the legs, making the legs swell. As a result, venous hypertension or high blood pressure in the legs develops, leading to skin discoloration, varicose veins, and ulcers. Some symptoms of CVI may include:

• Brown-coloured skin, often near the ankles
• Hard to treat leg ulcers
• Painful leg cramps or muscle spasms (charley horse)
• Pain when walking that stops when you rest
• Swelling in your legs or ankles
• Tight feeling in your calves or itchy, painful legs
• Uncomfortable feeling in your legs and an urge to move your legs (restless legs syndrome)
• Varicose veins

If you are experiencing any of these symptoms, book an appointment with our vascular specialists.

There are several treatments for chronic venous insufficiency such as regular exercise, weight management, compression stockings, and minimally-invasive surgical procedures like sclerotherapy and EVLT, surgical ligation and stripping, or phlebectomy.

Intermittent claudication is a circulatory problem brought on by insufficient blood flow, which causes pain — especially when active. If the lack of blood flow persists for too long, the affected tissue can become damaged. It is called intermittent because it tends to worsen when active. Some symptoms of intermittent claudication may include any of the following while active:

• Cramping
• Numbness
• Pain
• Tingling
• Weakness

If you are experiencing any of these symptoms, book an appointment with our vascular specialists.

If intermittent claudication is severe enough, an angioplasty may be required to widen the blood vessel and a stent placed to keep it open. Alternatively, bypass surgery takes blood vessels from elsewhere in the body and is used to bypass blood flow around the arterial blockage.

Deep vein thrombosis occurs when a blood clot develops in the deep veins of the legs, which may partially or completely block blood flow through your vein. It can also embolize and travel elsewhere in the body, including the lung, causing a pulmonary embolism (PE). Some symptoms of DVT may include:

• A feeling of warmth in the affected leg
• Pain in your leg (the pain often starts in your calf and can feel like cramping or soreness)
• Red or discoloured skin on the leg
• Swelling in the affected leg (rarely there’s swelling in both legs)

If you are experiencing any of these symptoms, you should seek medical consultation immediately.

A DVT is treated primarily with blood thinners. In some cases it is treated with thrombectomy where an incision is made in the blocked vessel, or a catheter is inserted to remove the blood clot. A stent may also be placed to ensure the vessel remains open.

A group of conditions that affect the flow of blood in and out of the kidneys such as thrombosis of the renal artery or vein wherein blood clots impede blood flow, renal artery stenosis, or aneurysm where the renal artery narrows or bulges, or atheroembolic renal disease where plaque embolizes from elsewhere in the body and travels to and blocks small renal arteries. Some symptoms of renal vascular disease may include:

• A sudden decrease in kidney function
• Blood in the urine
• Fever
• High blood pressure
• Nausea and vomiting
• Sudden onset of side pain between the ribs and the upper border of the hip bone (flank pain)

If you are experiencing any of these symptoms, book an appointment with our vascular specialists.

Surgical treatment for renal vascular disease is typically endovascular procedures such as an angioplasty to widen the narrowed or blocked artery and the placement of a stent to reinforce it and ensure it remains open, or bypass surgery to redirect blood flow around the renal artery to the kidney.