An aneurysm is a severe and life-threatening condition and often does not show symptoms. It is the abnormal bulging or enlargement in the wall of an artery. It happens when part of a blood vessel wall weakens, making it widen. Most aneurysms occur in the aorta, the main artery that carries blood away from the heart to the abdomen, pelvis and legs. An aortic aneurysm is usually discovered during health screenings or tests, so stay on top of your health by regularly visiting a doctor for assessment.

What Is Aortic Aneurysm?

An aortic aneurysm is the bulging and ballooning in the aorta, the large artery that carries blood from the heart through the torso and chest. Most deaths from aortic aneurysms are caused by:

• Rupture – aneurysm bursting and causing internal bleeding
• Dissection – the arterial wall layers split, and blood leaks in between

Narrowing, clots or blockages in a blood vessel caused by an aneurysm can lead to poor blood circulation, resulting in health complications such as stroke, organ damage or even death. Some types of aneurysms include:

• Abdominal aortic aneurysm (AAA)- Affects the aorta that supplies blood to the abdomen, pelvis and legs
• Thoracic aortic aneurysm (TAA) -Affects the part of the aorta that passes from the chest to the diaphragm
• Cerebral aneurysm – Affects a blood vessel in the brain

What Causes Aneurysms in the Aorta?

The exact cause of thoracic and abdominal aortic aneurysms remains unknown, but the following factors may increase your risk of developing this medical condition:

• Smoking – Directly damages the arterial walls, making them more susceptible to abnormal enlargement. It also increases your risk of hypertension.
• Atherosclerosis – Occurs when plaque builds up inside the blood vessels, limiting the supply of oxygen-rich blood to the organs and the rest of the body.
• Hypertension – High blood pressure can weaken the aortic walls and may cause an aneurysm to form.
• Chronic obstructive pulmonary disease (COPD) – A group of diseases causing airflow blockage and breathing-related conditions.
• High cholesterol levels
• A family history of aneurysm
• Cardiovascular disease

What Is the Difference Between Thoracic and Abdominal Aortic Aneurysm?

TAA occurs in the parts of the aorta that runs through the thoracic cavity in the chest area, including the section of the aorta that extends from the heart’s upper chambers (atria) to the diaphragm. On the other hand, AAA occurs in the portion of the aorta that passes through the abdomen. Both aneurysms may not cause noticeable symptoms until they rupture, leak or become larger. When symptoms do occur, they can include chest pain for TAA and abdominal pain for AAA.

Some symptoms of TAA may include:

• Deep and throbbing chest pain
• Trouble or pain swallowing
• Neck swelling
• Hoarseness
• High-pitched breathing
• Clammy skin
• Vomiting and nausea
• Rapid heart rate

Abdominal aortic aneurysm symptoms may include:

• Stomach pain that does not go away
• Sweaty or clammy skin
• Shock or fainting
• Dizziness
• Increased heart rate
• Nausea and vomiting
• Pain spreading from your abdomen or back to the pelvis, buttocks, groin or legs
• A throbbing and deep pain in the stomach

Always consult a doctor if you experience any symptoms listed here for proper diagnosis and evaluation.

How Is an Aortic Aneurysm Diagnosed?

Since aneurysms do not usually cause symptoms, un-ruptured aneurysms are often diagnosed during tests or exams for other health conditions. Your physician may perform the following initial physical examination to look for a possibility of aortic aneurysm:

• Feel your stomach area
• Listen to your heart for abnormal sounds
• Check whether the blood pressure in your limbs is weaker than normal
• Look for symptoms of other medical conditions that may be increasing your risk for aneurysm

The following tests may be conducted if your doctor suspects you may have an aortic aneurysm:

• Abdominal ultrasound
• Chest X-ray
• Magnetic resonance imaging (MRI)
• Abdominal computerized tomography (CT) to confirm the aneurysm size
• CT angiogram (CTA) to help with surgical planning

How to Reduce the Risk of Developing Aortic Aneurysm?

No specific lifestyle changes or therapy can prevent the aneurysm from developing, but maintaining good health overall can help. Get screened if aneurysms run in your family. Quitting smoking can also help reduce your risk, as a history of smoking accounts for about 75% of all AAAs cases. Approach your doctor for smoking cessation programs that may work for you.

Your doctor might prescribe medicines if you have a condition that raises your risk for an aneurysm, like high blood pressure, cholesterol or diabetes. These heart-healthy habits include:

• Eating a balanced diet
• Exercising
• Maintaining a healthy weight
• Quitting smoking
• Cutting down on alcohol consumption
• Reducing stress

Atherosclerosis is a buildup of plaque (mainly cholesterol deposits) within the arteries. This thickening of the artery walls decreases the flow of blood and oxygen to vital body organs and extremities, which can lead to severe cardiovascular diseases, such as:

Coronary heart disease (CHD) occurs when plaque builds up in the lining of the coronary arteries. The resulting narrowing of the arteries prevents blood and oxygen from flowing easily to the heart muscle, which may cause angina (pain, discomfort, or pressure in the chest). If blood flow is completely blocked by plaque or by a blood clot that forms inside the narrowed coronary artery, a heart attack may occur.

What is Atrial Fibrillation? 

Atrial fibrillation (Afib) is a heart rhythm abnormality that causes the upper chambers of the heart to beat in an irregular fashion. The irregular heart beat prevents blood from freely flowing to the lower chambers of the heart. When the heart is in Afib, it can cause a blood clot to form in the heart's top left chamber, typically in the left atrial appendage, which is the small sac in the heart's muscle wall. If a clot forms and breaks off in the blood stream it can travel to the brain and cause a stroke.

What are the Treatments Options for Atrial Fibrillation? 

Treatment options for Afib can be categorized to medications, surgical procedures, and non-surgical procedures. Medications for treating Afib may include drugs that control the heart rate and/or heart rhythm. Other types of medications may include blood thinners to prevent and treat blood clots.

Non-surgical procedures for treating Afib may include electrical cardioversion, radiofrequency catheter ablations, cryoablation, and the WATCHMAN implant.

We invite you to meet with one of our cardiac electrophysiologists to see if you are a candidate for these procedures.

What is a WATCHMAN Implant? 

The WATCHMAN implant is an umbrella-shaped device that is placed at the left atrial appendage through a catheter inserted into a large blood vessel. Once the WATCHMAN is placed, it seals the opening to this area preventing blood clot formation. Over time, new heart tissue grows over the implant and seals off the left atrial appendage. This device reduces the risk for clots and may be an alternative to taking blood-thinning medications for non-valvular atrial fibrillation.

Am I a Candidate for a WATCHMAN Implant? 

The WATCHMAN implant provides an alternative to individuals unable to tolerate lifelong use of blood thinning medications for Afib. WATCHMAN is FDA approved for reducing stroke in people with Afib not caused by valve problems. WATCHMAN may be used in individuals with:

• Atrial fibrillation not related to heart valve disease
• At increased risk of stroke
• Recommended for blood-thinning medications
• Able to take a blood thinner for a limited period of time
• Have an appropriate reason to seek a non-drug alternative to blood thinners

As with any medical procedure, a consultation with your doctor is recommended to determine your management and treatment plan. 

* WATCHMAN is a trademark of Boston Scientific Corporation 

What Should I Expect if My Doctor Recommends an Evaluation for a WATCHMAN Implant? 

If you are unable to tolerate long-term blood-thinning medications for non-valvular Afib, your doctor will request an evaluation by a cardiologist trained in placing a WATCHMAN device. These cardiologists are specialized in electrophysiology (EP) or in interventional cardiology with advanced training.

Preparing for the WATCHMAN Procedure 

Your physician will review your history, medications, and lab tests with you. Patients are commonly admitted on the day of the procedure. Instructions on preparing and arriving for the procedure are given in advance.

To determine the correct placement of the WATCHMAN device, a transesophageal echocardiogram (TEE) will be used to examine the structure of your heart and of the left atrial appendage.

After Your Procedure 

An individual's recovery process may vary person to person depending on the person's health status prior to the procedure and any changes to medication. Many patients are discharged from the hospital the next day. However, some individuals may require an extra day or two of hospitalization to tailor required medical therapy.

Although the goal of the WATCHMAN implant is to eventually discontinue blood-thinning medications, you will need to stay on these medicines after your procedure until follow up with your cardiologist. Once your cardiologist confirms blood-thinning medication is no longer required, you and your primary care doctor will be provided this information. While blood-thinning medication may be stopped, aspirin is usually continued. Use of aspirin and other medications may be prescribed by your primary care doctor.

You will receive a WATCHMAN Closure Device Implant Card. Carry this card with you at all times and show it when receiving medical care, dental care, or emergency care.

Carotid Artery Stenosis

As plaque builds up in the carotid arteries over time, it can lead to narrowing and eventually restrict blood flow to the brain. Carotid artery stenosis is a common cause of stroke. However, it is possible to have the condition and no symptoms at all.

What Is Carotid Artery Stenosis?

The carotid arteries are the two large blood vessels along each side of the neck (the pulse under your jawline). They provide the blood supply needed for oxygen to most of the brain and eyes. Stenosis means a narrowing or constriction in one or more passages within the body. Carotid artery stenosis occurs when the blood flowing through the main artery to the brain is narrowed or blocked.

What Causes Carotid Artery Blockage?

Narrowed or blocked carotid arteries are usually caused by atherosclerosis, a condition characterized by plaque buildup of fat, cholesterol, calcium and other substances in the blood. Too much plaque eventually narrows or hardens the arteries. Over time, pieces of plaque can break off and flow into the bloodstream, slowing or blocking blood flow to the eyes and brain.

Various factors can cause atherosclerotic plaque to form in the carotid arteries, including:

• Genetics
• High cholesterol
• Smoking
• Fatty diet
• Physical inactivity

Carotid artery stenosis is a chronic condition that affects people as they age. There are some cases when radiation treatment can cause some patients to develop carotid artery stenosis and not atherosclerosis. Some inflammatory conditions can cause irregularities in the carotid arteries as well.

What Are the Symptoms of a Blocked Carotid Artery?

Carotid artery stenosis can develop undetected and is often found by accident. If the narrowing causes symptoms, it can lead to transient ischemic attack (TIA) or stroke. Although TIA has similarities with stroke, it does not cause permanent damage to the brain. It cannot be found in a magnetic resonance imaging (MRI) or computerized tomography (CT) scan.

Use the F.A.S.T. acronym to help you recognize the most common signs and symptoms of a TIA or stroke according to the American Heart Association:

Face Drooping – Does one side of the face droop, or is it numb? Ask the person to smile. Is the person’s smile uneven?

Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

Speech Difficulty – Is speech slurred?

Time to call 911

Watch for other stroke symptoms, such as sudden:

• Numbness or weakness of the face, arm or leg, especially on one side of the body
• Confusion, trouble speaking or understanding speech
• Trouble seeing in one or both eyes
• Difficulty walking, dizziness, loss of balance or coordination
• Severe headache with no known cause

What Percent of Carotid Artery Blockage Requires Surgery?

The person’s symptoms and the amount of blockage in the carotid artery will determine the appropriate treatment for carotid artery stenosis. Treatment options range from medicines to opening the blood vessel with surgery. To diagnose carotid artery stenosis, your doctor will ask you about any warning signs you may be experiencing and order imaging tests to gauge the severity of the plaque buildup.

• If the narrowing of the carotid artery is less than50%, with or without symptoms, your doctor may recommend medication.
• If the narrowing of the carotid artery is between 50% and 70% and you have symptoms, your doctor may consider surgery in some cases.
• If the narrowing of the carotid artery is more than70% and you are having symptoms, your doctor may recommend surgery.
• If the narrowing of the carotid artery is more than70% and you do not have other symptoms, your doctor may recommend surgery if there is a low risk of complications.

Is Carotid Artery Surgery Dangerous?

There are two surgical procedures to treat patients with carotid artery stenosis:

What is congestive heart failure and cardiomyopathy?

Congestive heart failure is when the heart fails to sufficiently pump oxygenated blood. The heart continues to pump, but not as efficiently as a healthy heart.

Cardiomyopathy, which describes any disorder that affects the heart muscle, also can be a contributing cause of heart failure.

Three forms of cardiomyopathy are:

• Dilated cardiomyopathy, the most common type of cardiomyopathy, refers to an enlarged heart with an impaired ability to function properly.
• Hypertrophic cardiomyopathy is a rare condition that involves thickening of the left ventricle and stiffening of the heart, due to a genetic mutation in key proteins involved in heart muscle contraction.
• Restrictive cardiomyopathy occurs when the heart muscle becomes stiff due to progressive fibrosis or accumulation of abnormal substances and is unable to properly fill with blood.

Risk Factors

• Cancer therapy-associated heart failure
• Congenital heart disease or defects
• Coronary heart disease
• Diabetes
• Endocarditis
• Genetic diseases
• Heart rhythm disorders (cardiac arrhythmias)
• Heart valve disease
• High blood pressure
• Pregnancy-associated heart failure
• Previous heart attacks

Symptoms

• Abdominal Pain
• Loss of appetite
• Nausea, abdominal pain, and loss of appetite
• Persistent cough
• Shortness of breath
• Weakness and fatigue
• Weight gain

What is deep vein thrombosis?

Deep Vein Thrombosis (DVT) refers to blood clots that form in the deep veins of your body, most commonly in your legs. The deep veins are the ones that you cannot see on your body surface. When a blood clot (termed thrombus within the body) forms suddenly in a deep vein and stops the flow of blood towards the heart, the vein becomes bigger and can no longer effectively drain the affected leg of venous blood. If large enough, the obstruction and lack of proper venous emptying of the leg thus causes symptoms such as pain, tenderness, and swelling.

What is venous thromboembolism

Venous Thromboembolism (VTE) refers to the fact that blood clots in the deep veins formed in one part of the body are prone to break off and travel to the heart and lungs causing potentially lethal results.

What is a pulmonary embolus

When the blood clot travels to the lungs, it is called a pulmonary embolus (PE). Symptoms of a pulmonary embolus, when present, include sudden shortness of breath and chest pain, or shock.

High blood pressure is known as the silent killer because it usually has no warning signs. It is estimated that one in three U.S. adults have high blood pressure, or hypertension, defined as 130 (or higher) / 80 (or higher). Anything over 120 as the top number, regardless of the lower number, is considered elevated.

Such a broad definition of elevated blood pressure puts many people in the category of needing to manage blood pressure to prevent the condition from getting worse over time. Aging is one of the factors that increases risk for high blood pressure. Other risks include:

• Race/ethnicity (more common in African Americans)
• Being overweight
• Gender – After age 45 for men, after age 55 for women
• Family history of high blood pressure
• Lifestyle choices – Smoking, lack of exercise, too much alcohol, too much salt, not enough potassium

Prevent or Lower High Blood Pressure

If your doctor recommends medication, take it as prescribed. Medication doesn’t cure high blood pressure, but can help your body manage it. Changing habits can potentially help:

• Eat a healthy diet and limit salt
• Limit alcohol consumption
• Quit smoking
• Stay active
• Manage weight
• Manage stress

Reading the Numbers

Blood pressure numbers are a double measurement of the force of the blood against your arterial walls. The two measurements indicate how much pressure builds up in the arteries as the heart beats and then between the beats. The first, higher number is the systolic pressure, which indicates the heart’s pumping force.

The second, lower number is the diastolic pressure, which indicates the flexibility and clogging in the arteries.

What Blood Pressure Numbers Mean

The higher the blood pressure, the more resistance there is to blood flow. Your blood pressure will fall into one of the following categories:

• Normal/optimal
  • Systolic less than 120 mm Hg and diastolic less than 80 mm Hg (120/80)
• Elevated
  • Systolic is 120 to 129 and diastolic is less than 80 to 89
• High Blood Pressure Stage 1
  • Systolic between 130-139 or diastolic between 80-89
• High Blood Pressure Stage 2
  • Systolic at least 140 or diastolic at least 90 mm Hg
• Hypertensive crisis– requires immediate medical attention
  • Systolic over 180 and/or diastolic over 120

Hypertension is a sign that the heart is working too hard to pump blood through the circulatory system because of narrow and/or inflexible arteries. Your doctor may want to measure your blood pressure over several visits before making a diagnosis.

Peripheral Artery Disease

Sometimes cramping and leg pain are more than signs of aging, especially for people who smoke or have high cholesterol, diabetes and obesity. If you feel heaviness, aching or cramping in your feet, legs or buttocks when you walk or climb stairs, you may be one of more than eight million people in the United States, ages 40 and older, with peripheral artery disease or PAD.

What Is Peripheral Artery Disease?

Peripheral artery disease, also called peripheral arterial disease, is a common form of peripheral vascular disease that occurs when plaque builds up in the peripheral arteries, preventing blood flow to other parts of the body. PAD most commonly affects the lower extremities, like the legs and feet. It can also be used interchangeably with peripheral vascular disease.

Atherosclerosis is the leading cause of peripheral artery disease. It is a condition characterized by plaque buildup of fat, cholesterol, calcium and other substances in the blood. Too much plaque eventually narrows or hardens the peripheral arteries. Pieces of plaque can break off and flow into the bloodstream, slowing or blocking blood flow throughout the body, including the heart, brain, arms, pelvis and kidneys. However, some factors can also increase a person's risk of developing peripheral artery disease, such as:

• Aging
• Personal or family history of PAD, cardiovascular disease or stroke
• High blood pressure
• High blood cholesterol
• Smoking
• Type 2 diabetes

Peripheral artery disease symptoms are usually dismissed as signs of arthritis. But while arthritis pain centers in the joints, such as the knees or hips, peripheral artery disease pain is more general and felt in more areas of the body.

What Are the Warning Signs of Peripheral Vascular Disease?

Although symptoms vary from one person to another, watch for the following most common symptoms of peripheral artery disease:

• Pain, aching, heaviness or cramping in the legs when walking or climbing stairs that goes away after rest (also called intermittent claudication).
• Toenails and leg hair stop growing.
• One foot feels colder than the other.
• A foot or leg turns pale, discolored or blue.
• Leg weakness or numbness.
• A feeling of pins and needles in the leg or foot.
• Pain in the leg and foot when at rest (also called critical limb ischemia).
• Sores or wounds on the toes, feet or legs that may appear to have healed slowly or may not heal at all.

If you have symptoms of peripheral artery disease, your doctor will ask you about your medical and family history, conduct a physical exam and order tests and procedures, which may include the following:

• Ankle-brachial index – a painless exam that compares the blood pressure in your lower legs to the blood pressure in your arms.
• Duplex ultrasonography – a noninvasive test that produces images of the artery through sound waves and measures the blood flow in the artery to indicate the presence of blockage.
• Computed tomographic (CT) angiography – a noninvasive test that uses X-rays and a contrast agent (dye) to visualize the blood vessels in the arteries in your abdomen, pelvis and legs.
• Magnetic resonance angiography – a test that provides cross-sectional images like a CT without using X-rays.
• Angiography – a test that uses a contrast dye that is injected into the arteries and X-rays to show blood flow in the leg arteries.

Undiagnosed peripheral artery disease can lead to painful symptoms or complications, such as loss of a leg, coronary artery disease, stroke or heart attack. If you believe you are at risk, consult a healthcare professional to help you understand your condition.

Can Peripheral Artery Disease Be Treated?

Fortunately, some peripheral artery disease cases are treatable with healthy lifestyle changes and medication. Peripheral artery disease treatment depends on its severity, existing conditions and other conditions that may develop. PAD treatment will be designed to help you reach the following goals:

• Reducing your risk of major heart events, such as a stroke or heart attack
• Reducing symptoms of peripheral artery disease
• Improving your mobility, including walking, climbing stairs as well as performing other daily activities
• Lowering your risk of losing a limb
• Improving your quality of life

Your doctor may include heart-healthy lifestyle changes, an exercise program, medicine or a procedure in your treatment plan. The procedure aims to open or bypass blockages in your arteries.

Recommendations

The success of the treatment plan will also depend on your lifelong lifestyle choices. Some lifestyle modifications to consider are:

• Quit smoking.
• Choose a heart-healthy eating plan that includes fruits, vegetables and whole grains while avoiding foods rich in saturated fats, sodium, added sugars and alcohol.
• Maintain a healthy weight or lose 3-5% of your current weight if you are overweight or have obesity.
• Aim for 30 minutes of moderate exercise a day.
• Learn relaxation techniques to counter stress-related complications.
• Quality sleep

Peripheral Vascular Disease 

Not all cardiovascular conditions are felt as chest pain. Other parts of the body may start showing signs of cardiovascular disease. For instance, peripheral artery disease (PAD), a type of peripheral vascular disease (PVD), can be felt as leg and buttock cramps, which may go away with rest. However, some may not experience leg pain. With PAD, aches, cramps or discomfort while walking can occur in the thigh, hip or calf. 

What Is the Difference Between PAD and PVD? 

Peripheral vascular disease (PVD) is an umbrella term that includes PAD, lymphatic disease and peripheral venous disease. It is often used interchangeably with PAD. The American Heart Association recommends the term PAD to describe a disease affecting the blood vessels outside the heart.

Atherosclerosis is a condition that occurs when there is a buildup of fatty deposits in the arteries, causing them to become narrowed or blocked and preventing the oxygenated blood from reaching the rest of the body. If this condition affects the arteries that supply blood to the arms, legs or feet, it can lead to PAD. As people age, they are at increased risk of developing PAD. Other PAD risk factors include pre-existing conditions like diabetes, high blood pressure, smoking and high cholesterol levels.

Other disorders or conditions affecting the arteries may have symptoms like PAD, but not all PAD is caused by atherosclerosis. People with PAD are at risk of developing cerebrovascular and coronary artery disease, which could lead to stroke or heart attack. Atherosclerosis can affect other arteries in the body. This condition has different names depending on which arteries are affected:

Types of Peripheral Vascular Disease 

• Occlusive PVD– caused by blockage in the blood vessels.
• Atherosclerosis – the buildup of fatty deposits (plaque) in the arteries. It can result in narrowed arteries and reduce blood flow through them. 
• Buerger’s disease– involves swelling of the blood vessels, preventing blood flow and causing clot formation. It can lead to tissue damage, pain and even gangrene.
• Carotid artery disease– the narrowing of the carotid arteries, the main blood vessels carrying oxygenated blood to the brain.
• Deep vein thrombosis– blood clots in the veins found in the leg that can dislodge and travel to the lungs and heart, resulting in pulmonary embolism or blockage of the lung artery
• Lymphedema – swelling of some body parts due to lymph buildup. Lymph is a fluid in the lymphatic system traveling through the body to fight disease.
• Functional PVD– blood vessels narrow and widen due to other factors, such as stress, cold temperatures, smoking or work involving vibrating tools.
• Chronic venous insufficiency (CVI) - blood pooling in the legs because the vein valves do not work properly, preventing blood from the legs from returning to the heart.
• Raynaud’s disease– arteries spasm and temporarily restrict blood flow
• Varicose veins – enlarged, twisted veins visible under the skin and caused by venous insufficiency.

What Are the Warning Signs of Peripheral Vascular Disease? 

Working muscles need more blood than muscles that are not active. When someone has PVD, they can get leg cramps when they walk, work out or go upstairs. This pain means the muscles are not getting enough blood. Some people with PVD may think their pain is from something else or they might not feel any pain at all. Other PVD or peripheral artery disease symptoms are:

• The affected leg or foot has a lower temperature than the rest of your body
• Toe or foot wounds that heal very slowly or do not heal
• Thickened, opaque toenails
• Shiny skin on the leg
• Poor toenail growth
• Muscle weakness, numbness or heaviness
• Impotence
• Gangrene
• Decreased leg hair growth
• A bluish or pale color to the skin

How Is Peripheral Vascular Disease Diagnosed? 

Do not ignore it if you experience persistent leg pain or cramps when exercising. Abnormal swelling in your legs and feet may also be signs of a more serious problem, as well as the other symptoms mentioned earlier. Consult your doctor for a proper diagnosis if you experience pain or other unusual symptoms.

To help diagnose PVD, tell your healthcare provider about your symptoms, risk factors, and personal and family health or medical history. You also must disclose if you have been diagnosed with other medical conditions. Your doctor may perform several diagnostic procedures such as the following to diagnose PVD:

• Ankle-brachial index - comparing the blood pressure in the ankle with the blood pressure in the arm
• Computed tomography angiography (CTA) - a form of imaging that uses a dye injected into the blood vessels to allow the doctor to watch blood flow through the arteries more clearly.
• Doppler ultrasound - the use of sound waves to show blood flow through blood vessels
• Magnetic resonance angiography – the use of radio waves, a computer and a powerful magnetic field to evaluate blood vessels
• Peripheral angiography - the use of contrast dye and X-rays to identify narrowed or clogged arteries that supply blood to your limbs

What Is the Life Expectancy of Peripheral Vascular Disease? 

Life expectancy depends on a range of factors, such as the severity of the PVD by the time it was diagnosed, the patient’s overall health, other existing health conditions and many more. In general, people with PVD, regardless of whether they experience symptoms or not, are at an increased risk of stroke, heart attack and thrombosis. As such, patients with PVD should undertake lifestyle changes and other adjustments to help lower their risk of complications.

Can Peripheral Vascular Disease Be Cured? 

Currently, there is no specific cure for PVD. Peripheral vascular disease treatment aims to reduce symptoms and prevent them from worsening. Lifestyle changes, prescribed medications and exercise may be able to help.

• Stop smoking– smoking is a major PAD factor and increases your risk for stroke and heart attack. Work with us to discover programs and medications that may help you quit smoking.
• Physical activity – our rehabilitation program includes a supervised exercise routine you can do to help ease symptoms. Simple leg exercises, walking regimens and treadmill workouts can help, too.
• Diet – aim for a diet low in trans-fat and saturated fat to lower your blood cholesterol levels. Emphasize fruits, vegetables and whole grains in your diet while including low-fat dairy, fish, legumes and more.
• Medication – prescribed medications may include:
  • Anti-platelets to prevent blood clots
  • Medications to lower cholesterol
  • High blood pressure medications

Varicose veins are superficial veins that have enlarged due to increased pressure in your veins caused by incompetent, or leaking, valves that are much larger than spider veins.

Varicose veins are enlarged, swollen, and twisted veins that typically appear blue or purple in color and are visible just beneath the surface of the skin. They often occur in the legs and can cause discomfort, pain, or aching sensations.

A clotted varicose vein causes the classic phlebitis, hot and red and painful skin at the site of the clot. Besides the visible symptoms, physical symptoms are tiredness, restless legs at night, heaviness in the leg, pain, aching, itching, throbbing, and swelling, burning or a cramping sensation.

What is Venous Insufficiency?

Venous insufficiency is a health condition developed when the valves of the veins make it difficult for deoxygenated blood to move back to the heart. The blood instead accumulates in the leg veins, causing pain, discomfort, and abnormal discoloration in the leg area.

Learning how blood vessels, such as the arteries, capillaries and veins, work is essential to understand venous insufficiency. While the arteries carry blood away from the heart to nourish organs with oxygen-rich blood and nutrients, the veins carry deoxygenated blood toward the heart. The capillaries are channels through which the exchange of nutrients and oxygen occurs.

The veins have built-in one-way valves that help keep the blood flowing toward the heart. These valves are crucial in the arms and legs, where they prevent the backflow of blood in response to the pull of gravity.

When these valves do not work as they should, blood pools in the legs, puts increased pressure on the walls of the veins and causes poor blood flow from the legs to the heart, causing venous insufficiency. Valve dysfunction (usually hereditary), valve destruction after a deep vein thrombosis and blood clots are some of the reasons behind the reduced blood circulation.

Most symptoms are mild and not limb-threatening, such as:

• Enlarged and twisted veins in the legs that look rope-like and are close to the surface of the skin (varicose veins)
• Throbbing, pain or a feeling of heaviness in the legs
• Swelling of the legs or ankles (edema)
• Pain that worsens when standing up and gets better when the legs are raised
• Leg cramps
• Flaky and itchy skin
• Thickened and brownish skin discoloration below the knees
• Open sore or ulcer that does not heal—if your leg is affected, usually on the inside of the ankle

These symptoms are all signs of a problem with a person's blood circulation. If you have any of these symptoms, consulting a healthcare provider is a good first step to help determine whether you have venous insufficiency.

Is Venous Insufficiency Dangerous?

If left untreated, chronic venous insufficiency can progress and result in post-phlebitic syndrome, which causes chronic swelling, pain and discoloration of the skin. The skin can break down in severe cases, allowing an ulcer (open sore) to form. These ulcers are difficult to heal. Venous insufficiency can also lead to severe hemorrhage without proper treatment. 

What Causes Venous Disease?

Varicose veins, or inflammation with or without clots in the veins called phlebitis, excessive body weight and pregnancy are some causes of venous insufficiency. Some people are born with leaky or dysfunctional valves, while other venous insufficiency may be the result of trauma, prolonged standing, hormonal changes or deep vein thrombosis. It is more common in women (especially after multiple pregnancies) than in men and more likely in middle-aged or older adults. 

What Is Venous Insufficiency Surgery?

Treatment for venous insufficiency varies depending on the severity of the condition, the underlying cause and the patient's health history. Other factors to consider are the patient's specific symptoms, age and tolerance for medications or procedures.

The most common treatment involves prescription compression stockings, specialized elastic stockings that apply pressure at the ankle and lower leg, improve blood flow, and reduce leg swelling. Compression stockings come in various prescription strengths and lengths.

Additionally, some medications may help manage venous insufficiency, such as:

• Diuretics: Medications that draw excess fluid from your body, which is then excreted through the kidneys
• Anticoagulants: Blood-thinning medications
• Pentoxifylline (Trental): A medication that enhances blood flow

Some venous insufficiency is so severe that surgery may be necessary to help treat the symptoms. These surgical options are:

• Surgical repair of veins and valves
• Vein removal
• Minimally invasive endoscopic surgery: Uses a thin tube with a camera that helps tie off varicose veins.
• Vein bypass: Transplanting a healthy vein from another body part (usually in the upper thigh). This is typically used as a treatment option in severe cases.
• Laser surgery: A newer technique that uses lasers to fade or close damaged veins with precise and strong bursts of light.