What is it?
In our ageing population, vascular disease is a common cause of disability and mortality. There are more and more people affected by vascular diseases. The good news is that the range of diagnostic tests and treatment is also increasing.
Vascular disease or disease of the blood vessels can be categorized as
Diseases affecting the arteries
Most of the diseases affecting the arteries are associated with atherosclerosis or thickening of the artery walls due to the deposit of fats. This may cause blockage of the affected vessels resulting in a decreased blood supply to the organs or parts of the body that are supplied by these vessels.
Depending on which parts are affected, you may end up with:
Intermittent claudication (where you get muscle pain on walking)
Gangrene
Stroke
Kidney or other organ failure
Aneurysm (weakening of the artery wall which can rapture and cause death)
Diseases affecting the veins - These include:
Varicose veins
Deep vein thrombosis
This is another common vascular disorder where blood clots form in the veins
If the blood clots break away and move to the lung, these clots may get stuck in the lung arteries and cause pulmonary embolism which is life threatening
How is it Diagnosed?
A vascular surgeon uses his specialized clinical skill to assess and treat vascular diseases. He is supported by vascular physicians, vascular radiologists and vascular technologists who are skilled in the different aspects of vascular diseases.
Vascular technologists carry out non-invasive vascular tests
Non-invasive vascular investigations are tests done to assess the blood circulation without the need for injections, harmful radiation or other unpleasant interventions.
The technology used is sophisticated and the diagnostic accuracy is high.
The most effective is using ultrasound, which provides images of the blood vessels (using B mode scan) or detailed information about blood flow disturbances (using Doppler scan).
These two functions can be combined (Duplex scan) to provide a more comprehensive assessment
Invasive vascular investigations
The most important investigation for diagnosis of all vascular diseases is
angiography.
X-ray images of the arteries, veins and lymphatics are taken after injection of radio-opaque contrast medium into the blood vessels.
Digital systems, which can enhance these images, have improved the accuracy and safety of this investigation
Other imaging investigations include:
CT (computerized tomography) scans
Radio-isotope angiography
MRI (magnetic resonance imaging)
What are the symptoms?
Symptoms depend on where the vascular diseases occurs, examples are
Abdominal
Pain in the abdominal, back or groin area
Sudden, excruciating pain in the lower abdomen
Deep, aching, gnawing and/or throbbing pain that may last for hours or days
Legs
Peripheral vascular disease
Cramping pain in the leg muscles upon exertion which settles after a few minutes' rest
In the early stages, pain usually occurs in the calves
In the later stages, there may be constant pain at rest, ulceration of the lower leg, or even gangrene in the toes and feet.
What is the treatment?
General Management
Medication
Surgery
Other forms of treatment
Structured exercise programmes for intermittent claudication (leg pain)
Compression bandaging for the venous insufficiency (Poor or impaired flow of blood from the legs and feet to the heart)
Physical therapy for lymphoedema (Swelling in the arms or legs caused by a build-up of lymph fluid)
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