The vascular system is a network of blood vessels in the body, which can include arteries, capillaries and veins that carry blood to and from the heart. Problems of the vascular system are common and can be serious.There are a variety of factors that may make vascular disease more likely, including:
- Family history of vascular or heart diseases
- Illness or injury
- Long periods of sitting or standing still
- Any condition that affects the heart and blood vessels, such as diabetes or high cholesterol
Vascular disease includes conditions that affect the circulatory system. These are diseases of the veins, arteries and lymph vessels, as well as blood disorders that affect circulation. Vascular diseases include:
- Peripheral arterial disease
- Carotid artery disease
- Abdominal aortic aneurysms
Vascular disease can affect many organs and cause a wide variety of symptoms including:
- Chest pain
- Heart attack
- Leg pain or cramps
- Renal artery disease
- Uncontrolled hypertension
- Blood clots
- Bulging, swollen, purple or ropey veins
- Swelling in the arms or legs
Chronic mesenteric ischemia is caused by a narrowing of the blood vessels that deliver oxygen to the small and large intestine. Over time, the narrowing can become so severe that the blood flow is restricted and it becomes painful to digest food. Patients often develop a fear of eating. They present with postprandial (after meals) abdominal pain and progressive weight loss.
Pain is often described as dull and crampy and located in the mid-epigastric region. The management of this disease can be approached by both our endovascular and open techniques and depends upon the location and anatomy of the disease of each individual. Each patient will have a plan specifically detailed to their needs and wants and condition at presentation.
Thoracic outlet syndrome (TOS) is a syndrome involving compression at the superior thoracic outlet resulting from excess pressure placed on the structures passing between the muscles of the neck and shoulder. It can affect one or more of the nerves that innervate the upper limb and blood vessels as they pass between the chest and the arm. TOS can be broken down into 3 categories – neurogenic, arterial and venous.
The range of presenting symptoms is broad depending on the nature of the obstruction and the blood vessel/nerves affected. The cause is usually due to compression by the first rib and occasionally the presence of a cervical rib. The mainstay treatment involves an open procedure to remove the first rib and associated cervical rib if present.
Paget-Schroetter disease is sometimes considered a subset of thoracic outlet syndrome. It is sudden formation of deep venous thrombosis (DVT) of the upper extremity, which most often occurs after excessive use of the arm. The arm will swell and become painful. It is often due to compression of the vein from the bony anatomy of the shoulder. Paget-Schroetter disease is treated with a combination of minimally invasive techniques to break up the clot and open surgical techniques with removal of the bone causing the compression, most often the first rib.
May-Thurner syndrome is caused by compression of the the left iliac vein by the right iliac artery, which increases the risk of developing deep vein thrombosis (DVT) in the left leg. DVT is a blood clot that may partially or completely block blood flow through the vein.
Patients will present with swelling, pain or tenderness in the leg, feeling of increased warmth in the leg, redness or discoloration of the skin, or enlargement of the veins in the leg. The presentation may occur after excessive exercise of the leg. Even though DVT itself is not life-threatening, the blood clot has the potential to break free and travel through the bloodstream, where it can become lodged in the blood vessels of the lung (known as a pulmonary embolism). This can be a life-threatening condition.
The goals of treatment are to relieve symptoms, prevent embolization, and reduce the risk of long term complications. The approach is mainly minimally invasive and serves to break up the clot with treatment of the narrowed area, most commonly, with placement of a stent in the vein.
Wounds form for many different reasons, and the ability to heal wounds depends on many different factors. Wound care involves a comprehensive evaluation and a comprehensive treatment plan designed to address the underlying cause of the wound as well as manage the day to day care of the wound. Each plan will be designed to meet the needs specific to each individual patient. Patients will be evaluated for arterial and/or venous disease that can be associated with wound formation. Other medical conditions will also be addressed and controlled such as untreated elevated blood sugar. The wound care management may incorporate other doctors as part of a multidisciplinary care team. We are dedicated to finding and treating the underlying cause as well as using current techniques and devices designed to aid in wound healing in order to help heal wounds as quickly as possible.