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You are likely aware of the common symptoms associated with cardiovascular disease – shortness of breath, chest pain, fatigue – that make even light exercise nearly impossible and for some, potentially dangerous. But you may not be as familiar with diseases and issues related to other parts of the vascular system – such as the legs. Many vascular conditions of the legs are treated just like cardiovascular disease by your cardiologist, cardiovascular surgeon or vascular surgeon.
Vascular issues in the veins and arteries of the legs can build up over time – another similarity to heart disease. If left untreated, they can result in pain, limited mobility, ulcers, damage to organs, amputation and life-threatening conditions such as infection, gangrene and stroke.
If you are having any of these symptoms, please schedule an appointment today and consult with a vascular specialist:
At WakeMed, our goal is to alleviate pain, improve quality of life, detect vascular disease and treat it BEFORE a serious problem occurs. More often than not, we can successfully treat vascular conditions – often with minimally invasive procedures that make it possible for the patient to go home the same day.
A very common symptom of peripheral artery disease (PAD) in the leg is claudication, which typically presents as pain, cramping or fatigue in the leg with activity. Changes in the color of the skin on the leg and/or ulcers are obvious indicators of more advanced PAD.
PAD is the narrowing of arteries in the body. It is most commonly due to atherosclerosis (buildup of fat and cholesterol that turns into plaque on the inside of arteries). PAD in the legs is one of the main vascular conditions that make that walk in the autumn air difficult.
An aneurysm is a bulging of an artery at a weak spot. A peripheral aneurysm (PA) is one that occurs in an artery other than the aorta.
Peripheral aneurysms in the legs are most common in the popliteal artery, which runs down the back of the lower thigh to the knee, but can also occur in the femoral artery, which is in the groin area. If you have a peripheral aneurysm in one leg, it’s likely you have one in the other. A PA may also be an indicator of aortic aneurysm. Two out of three PA patients do not have any symptoms. Those who do may have an ulcer on a toe, a pulsating lump they can feel and/or pain or fatigue in the legs with or without activity.
Varicose veins can occur when the valves in the veins of the legs become weak or damaged and do not work properly. As a result, blood pools in the veins, creating lumpy, twisted, swollen veins. Family history, pregnancy, injury and obesity are common causes of varicose veins. Many people choose to have their varicose veins treated from an aesthetic standpoint. Intervention may become necessary if pain, blood clots or skin ulcers are present.
Blood clots form in the veins when blood flow is compromised.
They usually form due to:
Deep Vein Thrombosis (DVT) which is a blood clot in a deep vein of the leg, and pulmonary embolism (a blood clot that breaks free and travels to the lungs) can cause serious complications as well as death.
To diagnose vascular problems, we start with the basics – symptoms, family history, personal health and lifestyle, and a physical exam. A cardiologist may perform a simple test like an ankle brachial index (ABI) screening to compare the blood pressure in the arm with the blood pressure in the legs. The blood pressure in the legs is typically higher than the blood pressure in the arm.
Additional imaging tests also help the vascular specialist pinpoint the location and extent of a vascular issue as well as how to best treat it. After a history and physical exam, I usually check ankle brachial indices and then perform an arterial duplex (ultrasound) of the arteries of the lower extremities to confirm my suspicion of PAD.
Several treatment options exist for vascular conditions. Treatment begins with lifestyle changes. Healthy lifestyle changes alone can often make a big difference in the fight against vascular disease. “This means keeping your blood pressure, cholesterol and diabetes under control, improving your diet, exercising and quitting smoking. Medications such as blood thinners may also be prescribed to help maintain blood flow.
A procedure is necessary when arteries become so clogged that blood flow is diminished to the point where oxygen is not reaching the leg muscles. When our legs do not get the oxygen they need, serious problems, such as ulcers, infection and gangrene can occur. If left untreated, these serious conditions can lead to amputation, organ failure and a higher risk of mortality.
Interventional cardiologists & surgeons frequently perform the following procedures to treat Peripheral Vascular Disease:
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