| Vascular disease | |
|---|---|
 | |
| Veins and arteries | |
| Specialty | Angiology  |
| Types | Peripheral artery disease,[1] Renal artery stenosis[2] |
| Diagnostic method | Venography, Ultrasound[3] |
| Treatment | Quit smoking, Lower cholesterol[4] |
Vascular disease is a class of diseases of the vessels of thecirculatory system in thebody, includingblood vessels – thearteries andveins, and thelymphatic vessels. Vascular disease is a subgroup ofcardiovascular disease. Disorders in this vast network of blood and lymph vessels can cause a range of health problems that can sometimes become severe, and fatal.[3]Coronary heart disease for example, is the leading cause of death for men and women in the United States.[5]
There are several types of vascular disease, including venous diseases, and arterial diseases, and signs and symptoms vary depending on the disease. Those of the arterial system are associated with blood supply to tissues and its obstruction due to blockages or narrowing. In thevenous system disorders are often caused by a slow return of blood due to insufficient valves, or to ablood clot.[6]
Most disorders of the veins involve obstruction such as athrombus or insufficiency of thevalves, or both of these.[7][8][9] Other conditions may be due toinflammation.
Phlebitis is theinflammation of a vein. It is usually accompanied by ablood clot when it is known asthrombophlebitis. When the affected vein is a superficial vein in the leg, it is known assuperficial thrombophlebitis, and unlike deep vein thrombosis there is little risk of the clot breaking off as anembolus.[10]
Venous insufficiency is the most common disorder of the venous system, and is usually manifested as eitherspider veins orvaricose veins. Several treatments are available includingendovenous thermal ablation (using radiofrequency or laser energy),vein stripping,ambulatory phlebectomy, foamsclerotherapy,laser, or compression.[citation needed]
Postphlebitic syndrome is venous insufficiency that develops followingdeep vein thrombosis.[11]
Venous thrombosis is the formation of athrombus (blood clot) in a vein. This most commonly affects adeep vein known asdeep vein thrombosis (DVT). DVT usually occurs in the veins of the legs, although it can also occur in the veins of the arms. Immobility, active cancer, obesity, traumatic damage and congenital disorders that make clots more likely are all risk factors for deep vein thrombosis. It can cause the affected limb to swell, and cause pain and an overlying skin rash. In the worst case, a deep vein thrombosis can extend, or a part of a clot can break off as anembolus and lodge in apulmonary artery in the lungs, known as apulmonary embolism.The decision to treat deep vein thrombosis depends on its size, a person's symptoms, and their risk factors. It generally involvesanticoagulation to prevents clots or to reduce the size of the clot.Intermittent pneumatic compression is a method used to improve venous circulation in cases of edema or in those at risk from a deep vein thrombosis.[citation needed]
A clot can also form in asuperficial vein (superficial venous thrombosis) which is normally not clinically significant, but the thrombus can migrate into the deep venous system where it can also give rise to a pulmonary embolism.[12]
Theportal vein also known as thehepatic portal vein carries blood drained from most of thegastrointestinal tract to theliver.Portal hypertension is mainly caused bycirrhosis of the liver. Other causes can include an obstructing clot in ahepatic vein (Budd Chiari syndrome) or compression from tumors or tuberculosis lesions. When the pressure increases in the portal vein, acollateral circulation develops, causing visible veins such asesophageal varices.[citation needed]
Avascular anomaly can be either avascular tumor or abirthmark, or avascular malformation.[13] In a tumor such asinfantile hemangioma the mass is soft, and easily compressed, and their coloring is due to the dilated anomalous involved veins.[14] They are most commonly found in the head and neck.Venous malformations are the type of vascular malformation that involves the veins. They can often extend deeper from their surface appearance, reaching underlying muscle or bone.[15] In the neck they may extend into thelining of the mouth cavity or into thesalivary glands.[14] They are the most common of thevascular malformations.[16] A severe venous malformation can involve the lymph vessels as alymphaticovenous malformation.[14]
Vascular disease is a pathological state of large and medium muscular arteries and is triggered byendothelial cell dysfunction.[22]
Because of factors likepathogens,oxidizedLDL particles and otherinflammatory stimuliendothelial cells become active.[23]
The process causes thickening of the vessel wall, forming a plaque that consists of proliferatingsmooth muscle cells,macrophages andlymphocytes.[24][25]
The plaque results in restricted blood flow, decreasing the amount of oxygen and nutrients that reach certain organs.[26]
This plaque can also rupture, causing the formation of clots.[27]
Diagnosing vascular disease can be complex due to the variety of symptoms vascular diseases can cause. Reviewing a patient'sfamily history and conducting aphysical examination are important steps in making a diagnosis. Physical exams may differ depending on the type of vascular disease suspected. For example, in the case of aperipheral vascular disease, a physical exam consists of checkingblood flow in a patient's legs.[28][29]
Treatment varies based on the type of vascular disease being treated. In treating renal artery disease, a 2014 study indicates that balloon angioplasty can improve diastolic blood pressure and potentially reduce antihypertensive drug requirements.[30] In the case of peripheral artery disease, treatment to prevent complications is important; without treatment, sores organgrene (tissue death) may occur.[citation needed]
More generally, treatments for vascular disease may include:[4]
