vascular diseases

What is the circulatory system?

In the human body, a branched network, like no other, of tubes that have one purpose, the transport of blood, stretches for many kilometers.
The blood moves in two pathways – one from the heart to the tissues and the other from the tissues to the heart.
There are three main systems that carry blood: the arterial system, the venous system and the lymphatic system. These are branched “road” systems that lead the blood, in an exemplary order in different and diverse traffic routes. The arterial system carries oxygenated blood from the heart to the organs.
The venous system carries oxygen-free blood, but rich in carbon dioxide, from the organs to the heart. The connection between the arterial and venous system is through the capillaries, which are a bridging site between these two systems. The lymphatic system leads the fluid from the intercellular space, mainly in the remote areas of the body, towards the center of the body where this system drains into the venous system. In each of these systems, pathological disorders may appear in the function, the neglect of which may cause a worsening of the clinical prognosis and sometimes pose a danger to the life of an organ and even a danger to life in extreme cases.

Diagnosis of vascular diseases

Diseases may arise in any of the mentioned systems, the arterial system, the venous system and the lymphatic system. The arterial diseases will mostly be obstructive diseases, that is, diseases in which there will be some disturbance in the normal blood flow to the tissues. Sometimes there is a pathological expansion of the artery. This expansion, when the diameter of the artery is greater than 1.5 times its basic diameter, is called an Aortic aneurysm. Diagnosing obstructive diseases for the most part will occur when relevant clinical signs while the diagnosis of aneurysms is for the most part random, in imaging tests done for a completely different purpose.

The treatment of obstructive as well as aneurysmal diseases is performed, after thorough consideration, by an experienced vascular surgeon.

Venous diseases are divided into two types

1. Diseases in which a blood clot forms in these systems.

2.Diseases in which the valves inside the veins do not function properly, are insufficient and as a result the said veins swell and cause edema in the limbs, mostly the lower ones.

The evaluation of the venous pathology and the indication of an appropriate treatment plan is also carried out by a specialist vascular surgeon. The lymphatic pathology is the most problematic of all. This is a pathology that has no surgical cure and its treatment is based on preventing the worsening of the existing condition. Although in these cases the initial assessment of the patients will be by a vascular surgeon, but the main treatment will be by lymphatic masseurs whose work is invaluable.

What tests are used to diagnose vascular diseases?

The diagnostic tests are non-invasive and they include-
Ultrasound imaging test – used to assess the diameter of the blood vessels. In the majority of cases, it is used to evaluate the diameter of blood vessels, mainly in the search for pathologically dilated blood vessels.

Doppler test – checks the blood flow in the blood vessels (it is used to evaluate the flow data during the arterial phase). The mechanism is a physical effect called the Doppler effect, in which the speed of flow in blood vessels is measured. This test is.

Duplex test – includes two components, the Doppler component detailed above and the ultrasound component in which the structure of the blood vessels is demonstrated in addition to the speed of blood flow in them. This test is used to evaluate flow data in both arterial and venous blood vessels. For example – duplex leg veins and duplex carotid arteries. It’s a very effective and reliable test. but the quality of this test is affected by the quality of the technician performing the test.

Computerized Tomographic Angiography test (Computerized Tomographic Angiography – CTA) – This test is essentially a simulated, virtual catheterization. A contrast material is injected into the vein and according to the built-in timing of the CT device, the arterial and venous system are scanned along the entire length of the examined segment. This test is very effective and allows you to get reliable information about blood vessel data, with software that does not depend on the technician performing the test.

Magnetic Resonance Angiography (MRA) – This test is very similar to the CTA test but is based on a different technique. Its great advantage is its ability to provide very reliable information about the blood flow in small and calcified blood vessels in the calves, for example, for which the CTA test result is unreliable due to the inability to differentiate between the calcium in the artery wall and the flowing contrast material. Another advantage of this test is the fact that the contrast material used in this test, gadolinium, does not cause kidney damage.

Vascular catheterization, angiography – an invasive procedure based on the injection of contrast material directly into the blood vessels, both artery and vein. Currently used as a therapeutic procedure mainly.

What are the most common vascular diseases?

There is a difference between diseases in the arterial tree and diseases in the venous tree. Diseases in the arterial tree include, as mentioned, mainly obstructive diseases, due to atherosclerosis, the clinical manifestation of which will be – a stroke in the case of a flow disorder in the carotid arteries, a myocardial infarction – in the case of a flow disorder in the coronary arteries (the arteries that supply blood to the heart), a walking disorder – in cases of Impaired blood flow to the legs. Diseases in the venous tree will mostly be diseases that result from damage to the normal function of the valves in the blood vessels, which become non-spiking and as a result the veins expand, mostly in the lower limbs.

Can vascular disease be life-threatening?

Disease in the arterial blood vessels may certainly endanger the patients’ lives. Arteriosclerosis may manifest, as mentioned above, either in the form of an obstructive disease or in the form of an aneurysmal disease, in which the diameter of the blood vessels expands to a considerable extent relative to its original diameter. As the diameter of the blood vessel increases, the wall of the blood vessel becomes thinner and accordingly the risk of its tearing, rupture increases.

In light of these data, care must be taken to evaluate the arterial blood vessel data and balance the risk factors for the sclerotic disease.

Treatment of vascular diseases

The role of the vascular surgeon is to evaluate the patient’s vascular data, to define whether there is a problem with the blood flow in the various blood vessels, what is the severity of this problem and what is the optimal treatment for said problem. In light of the fact that arteriosclerosis does not heal locally but rather systemically, the vascular surgeon’s role is complex and includes reference to all of the patient’s data – what is the disease the patient is suffering from, its degree of clinical severity, the patient’s age, other diseases the patient is suffering from, etc.

This complex weighing will ultimately result in optimal treatment for the patient. This treatment may be conservative treatment based on balancing risk factors, catheterized, endovascular treatment in which the blood vessel is treated with a percutaneous approach or surgical treatment in which the type of surgery is adapted to the nature of the disease being treated, including the installation of bypasses for the blocked arterial segments.