Major advances have been made in the treatment of vascular disease over the past 15 years. Now, doctors have a much better understanding of the causes processes of vascular disease and are better at treating it with medical therapy like pills, as well as with lifestyle changes.
Another big advancement is the surgical procedures available. Before only bypass surgery was an option, while today, many patients can be treated via endovascular techniques which are done under local anaesthetic.
How will I know if I have a vascular supply problem?
Let’s use your legs as an example. The most common symptom of diminished blood flow is arterial claudication. This is when you develop an intense burning pain in the calf while walking that disappears when you stop to rest. When a muscle is stressed by exercise, it needs more blood to supply it with oxygen and fuel. If there’s a narrowing in the arteries supplying blood to the muscle, a burning sensation is felt just like with exercise. As the disease progresses the painful sensation might be present even at rest. This is a tell-tale sign that there’s not enough blood supply to the muscle.
Why do people develop this condition?
Narrowed arteries are usually caused by atherosclerosis. This is a disease that may occur in all of the arteries of the body. Depending on the place where symptoms occur, we call it by different names. If it’s in the blood vessels of the heart it’s called coronary artery disease. If it’s in the blood vessels of the brain it’s cerebrovascular disease. When it’s found in the blood vessels in the legs it’s known as peripheral arterial disease. There are many factors involved in causing this disease, but the most important risk factors are:
- Genetic susceptibility. If any of your parents had it your chances to get it are much higher
- High cholesterol
I have poor blood supply to my legs how can I fix it?
First of all, your risk factors need to be controlled. Quit smoking. If you’re diabetic, suffer from hypertension or high cholesterol, you need to get the best medical management for it. You should also start exercising, not only does this have major metabolic advantages, but it forces your body to create new blood vessels in areas suffering from decreased blood flow. However, your exercise programme should be monitored by your doctor. Many people who have significant vascular impairment can actually use exercise to treat the condition.
How will I know if I need surgery?
Your doctor will refer you to a vascular surgeon who’ll run tests and assess the need for surgical intervention. If it’s decided that something must be done, an arteriogram will be obtained. This is done by a special kind of CT-scan called a CT-arteriography.
What options for intervention are available and how is that decision made?
You’ll need to be assessed and the roadmap of the arterial occlusion, as well as your risk factors for surgery be considered. As a general rule, the shorter the obstructions in the arteries, the more amenable they are to ballooning and/or stenting. This is done via an endovascular (non-operation) approach. If you have a series of long occlusions, it’s likely you’ll need bypass surgery provided you’re healthy enough for such major surgery. It should also be appreciated that your surgeon can only bypass an occlusion if there’s an adequate segment of open arteries below the obstruction. Even so, sometimes the pattern of disease makes this impossible due to occlusions all the way down into the small arteries of the lower leg.
Are there other forms of vascular disease in addition to atherosclerosis.
Yes, of course there are many diseases that may affect the blood vessels. Some of these can be treated with medication only, while others may need intervention ranging from endovascular procedures to complex, major open surgery.