Vascular and Endovascular surgery at RxDx
Vascular and Endovascular surgery is a surgical subspecialty that provides comprehensive care for the diseases of arteries and the veins (Blood vessels) except those of the heart and brain).
Who are at Risk?
Vascular diseases are common in people who smoke and have atherosclerosis (development of fatty fibrotic plaques inside the arteries). They then have a high risk of heart attack, stroke or kidney failure. It is essential to identify them before they manifest and can be prevented by control of risk factors. Stroke is caused by various causes, and one of them is blockage of the carotid arteries (which are present in the neck and supply the brain).
Usually, strokes are preceded by mini-strokes (TIA) which recover soon and may herald a significant stroke in future. In suitable patients, major stroke can be prevented by surgery to clear blocks in the arteries. Other arterial diseases treated by vascular surgeon include damaged blood vessels, tumors of the arteries (Carotid body Tumors), diseases of the blood vessels supplying intestines (mesenteric disease), arteriovenous malformations, etc.
Following are some of the arterial and venous diseases and their presentations:
- Ischaemia (PAD-Peripheral arterial disease) is a condition associated with restricted blood supply to tissues caused due to blockage of arteries. Ischaemia not only causes a shortage of oxygen which is needed for cellular metabolism, but it also leads to reduced availability of nutrients and inadequate removal of metabolic wastes from the affected area. Ischaemia in limbs can cause pain while walking (Claudication); blackish discoloration of toes/distal part of the foot/ hand (Gangrene) and ulcers that are resistant to healing.
- Varicose veins(dilated veins) are abnormally enlarged veins that are usually blue, purple, or skin-colored. They appear dilated and twisted and may seem as raised above the surface of the skin. They commonly affect adults with an increased prevalence in women. Various risk factors include advanced age, prolonged sitting/standing, obesity, pregnancy, hormone therapy (HT), birth control pills, injury, prior vein surgery, a history of blood clots, and family history. They could be asymptomatic or cause vague symptoms such as discomfort, ache, swelling or can present with skin changes around the ankles and frank non-healing ulcers. They result from leaky valves in the veins which usually should maintain unidirectional flow towards the heart.
- Deep vein thrombosis (DVT) is yet another venous condition often missed. This could result from the stasis of blood, obstruction to flow by narrowing or tendency of clotting. If not diagnosed and treated, there is a risk of clot going up the bloodstream and lodging in lung arteries (Pulmonary embolism) causing cardiac failure.
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