Types of Peripheral Vascular Disease

The term “peripheral vascular disease” refers to several specific conditions.

Abdominal Aortic Aneurysm
Abdominal aortic aneurysm (AAA) can be compared to a weak spot on an old tire that creates a bulge in the lower abdominal aorta, which is the main pipeline for blood to the legs. 

Adult men over age 60, especially those who smoke, have the highest risk of developing AAA.

Small aneurysms have a low risk of rupture and often warrant only watchful waiting. If the AAA enlarges, repair of the aneurysm should be considered.

The two choices of treatments are traditional/open surgery or endovascular repair. Patients should consult with their physicians about the best course of treatment for their individual case.

Carotid Artery Stenosis or Vertebral Artery Stenosis
Most people with carotid artery disease have no symptoms. Often the first sign of narrowing is a stroke or transient ischemic attacks (TIA). TIAs, or mini-strokes, can cause a temporary decrease in blood flow to the brain. This can cause symptoms such as partial blindness, numbness, tingling or weakness in the arms or legs. Patients with TIAs are more likely to have strokes. Patients with vertebral artery stenosis may have symptoms of dizziness or no symptoms at all. 

An angiogram is recommend for patients who have symptoms of carotid artery stenosis and greater than 50 percent blockage showing on a Doppler test. If these tests confirm the blockage, then a patient may need carotid endarterectomy, or revascularization. 

In some cases, patients may have balloon angioplasty or stenting. 

Currently, only a few centers have an expertise in carotid or vertebral artery stenosis.  Loyola University Health System is a participant in clinical trials to study and perfect the use of the treatment.

Extremities (arms, legs)
Oftentimes, no symptoms are evident until the artery has significantly narrowed. However, the usual symptoms are pain in the arm, shoulder, buttock, thigh or calf muscles when you walk or exercise. The pain usually goes away if you rest. 

In severe narrowing of the artery, you may have pain even when you are at rest. In certain patients, especially those patients with diabetes, this narrowing may cause wounds on the feet that take longer to heal or cannot be healed. 

Recommended treatments include lifestyle changes or balloon angioplasty and/or stent.

Renal Artery Stenosis
Patients with renal artery stenosis often have blood pressure or heart failure that is difficult to control. Also, they may have abnormal kidney function. Patients do not have pain associated with this disease. 

The first line of treatment for renal artery stenosis is balloon angioplasty and stent placement. Surgery is recommended only in severe cases. 

Sexual Impotence
In some cases, male sexual impotence can be due to narrowing of the artery that supplies the pelvic area. These patients usually have buttock pain during walking or exercise. 

For these patients, opening the artery using balloon angioplasty and a stent can bring relief. 

Varicose Veins
Varicose veins most commonly develop in the legs and ankles. They are caused by weakened valves that have stopped functioning properly and limit the blood from reaching the heart. Varicose veins may be inherited, caused by age or may result from an increased pressure on the legs veins, such as being overweight, being pregnant or working in an occupation that requires standing for long periods of time.

While varicose veins are common and not usually a sign of a serious medical problem, patients should have them checked to be sure they are not a result of something more serious such as a blockage in the deeper veins, called deep vein thrombosis.

Medical treatment of varicose veins may be done in the Center for Heart & Vascular Medicine, while cosmetic treatments are performed at the Loyola Aesthetic Center in Oakbrook Terrace. Medical treatments include varicose vein ablation, phlebectomy and use of compression stockings or hose.