Vascular Disease Overview
What is Vascular Disease?
Vascular disease refers to an abnormality of the blood vessels (veins or arteries). Peripheral vascular disease (PVD) refers to abnormality of blood vessels throughout the body except those in the heart and brain. Arteries carry blood from the heart to other parts of the body. Veins carry blood to the heart from the legs and other organs in the body. Vascular disease results from degeneration of normal arteries and veins as the result of the normal aging process and can be made worse by certain factors that damage blood vessels. Treatments aimed at reducing vascular damage can slow down and sometimes reverse vascular disease, or give the body a chance to “heal itself.” When these kinds of efforts are not sufficient, surgery may be required to correct abnormalities.
Who Treats Vascular Disease?
Since vascular disease is a relatively common problem, there are many physicians who treat vascular disease. These include family practitioners and general internists, cardiologists, neurologists, nephrologists, radiologists and vascular surgeons. It is not uncommon for patients to have coordinated care between several of these physicians who specialize in vascular disease.
- Family Practitioners and Internists: focus on detection of disease and reducing the risk of disease progression (“risk factor modification”).
- Cardiologists: focus on treating vascular diseases of the heart, although some of them also treat peripheral arterial disease (PAD).
- Neurologists: treat vascular disease that affects the brain.
- Nephrologists: treat vascular disease that affects the kidneys.
- Radiologists: are often called in as consultants to interpret images (CT, MRI, ultrasound, angiography) that are used to identify vascular disease; some radiologists perform procedures to treat diseased blood vessels. In general, radiologists do not provide primary evaluation and/or treatment for most vascular conditions.
- Vascular Surgeons: physicians that are exclusively dedicated to the evaluation and treatment of vascular disease outside the heart and brain. Vascular surgeons can:
- Diagnose vascular conditions and interpret CT, MRI, ultrasound, and angiography images
- Make treatment recommendations including medical and surgical options
- Perform any procedures that may be required to treat vascular conditions
Despite being “surgeons,” about 66%-75% of patients treated by vascular surgeons are managed medically, generally in collaboration with the patient’s primary care practitioner. For patients who require surgery, 60-70% can have “minimally invasive” procedures performed—either as an outpatient or with a brief, one- to two-day hospital stay. Recovery periods for minimally invasive procedures are typically less than two weeks at home.
Common Vascular Conditions
Vascular conditions can be divided into diseases of the arteries (arterial) and diseases of the veins (venous). Common vascular conditions are listed below. Use the link for a deeper discussion about each one.
Common Arterial Conditions:
- Peripheral Arterial Disease (PAD)
- Critical Limb Ischemia (CLI)
- Carotid Artery Disease
- Aneurysms (especially aortic aneurysms)
Common Venous Conditions:
- Varicose Veins, Reticular Veins and Venous Telangiectasias (Spider Veins)
- Pelvic Venous Congestion Syndrome (PCS)
- Venous Compression Syndromes
- Deep Vein Thrombosis (DVT)
- Chronic Venous Insufficiency (CVI)