Vascular Disease Treatments through Interventional Radiology

Peripheral vascular disease is a general term for vascular diseases outside of the heart and brain. Because the vascular system runs throughout the entire body, symptoms related to vascular disease are diverse. These can range from mild cramping pain and swelling to serious infections and ulcers leading to limb loss.

Peripheral vascular disease can be broken down into arterial and venous disease. Problems with both of those vascular systems can be further separated into large vessel or small vessel disease, as well as numerous subcategories.

Peripheral Artery Disease

Peripheral artery disease, also known as PAD, is a common disease affecting more than 200 million people worldwide. Individuals with diabetes, hypertension, kidney disease, and a history of smoking are at higher risk for development of the disease. It is more common in the arteries of the legs, but can also be present in the arm.

PAD is a gradual narrowing and possible blockage of arteries due to thickening of the walls of the artery from fat or cholesterol plaques. This can result in pain or ulcers distal to the artery disease. By restoring blood flow to areas on the other side of arterial blockages, we can improve pain and heal ulcers.

Chronic Limb-Threatening Ischemia

When peripheral artery disease progresses to the point where it causes unrelenting pain at rest or ulceration for over two weeks, it is called chronic limb threatening ischemia (CTLI). Patients with CTLI are at risk for amputation and should seek medical evaluation immediately.

Generally, the earlier a patient seeks a vascular expert, the better their chances of avoiding limb loss. Patients with CTLI are also at elevated risk for heart attacks and strokes, so optimizing their medical therapy is very important.

Venous Disease

Lower extremity venous insufficiency, also known as venous reflux or venous incompetence, is a condition where the one-way valves of the veins become damaged and malfunction. This results in local areas of high venous pressure that can cause painful varicose veins, spider veins, swelling, and skin changes.

Venous insufficiency can generally be categorized as deep or superficial, and primary or secondary. The superficial venous system is made up of all of the veins outside of the muscles within the fatty tissue beneath the skin. The deep venous system is made up of the veins within the muscles and around bones. There are also veins connecting the deep and superficial systems, called “perforators,” which can malfunction.

Superficial venous disease is more common, and thankfully, is treatable with a variety of therapies, including sclerotherapy, ablation, and phlebectomy. Currently, deep venous insufficiency is mostly managed with conservative therapy.

Primary venous insufficiency refers to malfunction of the valves without a leading incident, whereas secondary venous insufficiency refers to venous disease caused by some event, namely a deep venous thrombosis (DVT). There are some treatable causes of DVT, such as iliac vein compression, also known as May-Thurner Syndrome.

Contact us to learn more about vascular disease treatments through interventional radiology.