Vascular disease affects arteries, veins or the lymphatic system.
Peripheral arterial disease
Arterial disease can appear in many forms, although in the Western world, atherosclerosis is the commonest cause. The symptoms of arterial disease depend on the vessels affected. Recently the UK government has recognised the significance of these diseases and has recommended an aneurysm screening programme for men over 65, which should be rolled out over the UK over the next few years. The early treatment and prevention of stroke has also received publicity lately with the F.A.S.T awareness campaign.
Examples of arterial disease
Intermittent claudication
Leg cramps, or claudication, can develop when the arteries to the legs are diseased.
Carotid artery disease
Narrowing of the arteries in the neck which transmit blood to the brain can be a cause of stroke. Early detection of this problem and treatment to correct it has been shown to reduce the risk of stroke. Atherosclerosis or cholesterol build-up is the commonest cause of arterial narrowing, called stenosis. Repair of the artery, known as carotid endarterectomy is a well established treatment for this problem.
Abdominal aortic aneurysm
The major arteries, including the aorta, can become widened. This is known as an aneurysm. If untreated an aneurysm could be at risk of rupture. the normal aorta is below 2cm in diameter, in most adults. If it dilates to greater than 5.5cm it becomes safer to treat it surgically than leave it under observation, except in particularly elderly or unfit patients.
Venous disease
The commonest form of venous disease is varicose veins. This can affect up to one-quarter of the adult population. Until recently the treatment options were limited to surgical stockings, surgical stripping, or sclerotherapy for minor veins.
In the last decade new treatment options have been developed to treat varicose veins, which include endovenous laser treatment, radio-frequency ablation, and foam sclerotherapy.
Each of these treatments has established a role alongside the traditional treatment options and in many cases these newer options are favoured.
Diagnosis
To deliver the correct treatment it is essential that the diagnosis is made using the clinical expertise of the specialist, supported by the utilisation of the most up-to-date investigative tools.
For example the Veinlite transilluminator to enhance sclerotherapy treatments
Imaging at point-of-care is now standard practice in many parts of the world. I offer immediate assessment using state-of-the-art colour duplex ultrasound imaging in the clinic using Sonosite Micromaxx equipment.
Treatment
The optimal treatment may vary from one individual to another. What is most important, is that the options are considered and discussed. Ultimately you should be in a position to decide what is right for you.
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