Diseases and Conditions
At the Hurley Vascular Center, our team of expert vascular physicians and medical professionals is committed to successfully treating all circulatory-system disorders, including:
Arteriosclerosis, Atherosclerosis
Dissecting aneurysm (Aortic dissection)
Peripheral artery disease (Peripheral vascular disease)
Venous ulcers (Stasis leg ulcer)
Abdominal aortic aneurysm
An abdominal aortic aneurysm (AAA) is a bulging, weak area in the lower part of the aorta, the main blood vessel that supplies blood to the body. Small aneurysms generally pose no threat. However, the aneurysm will grow larger and eventually rupture (tear) if it is not diagnosed and treated. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause bleeding that can be life-threatening and requires emergency surgery.
What Causes an AAA?
Aneurysms are caused by the breakdown of proteins in the vessel wall. These proteins, collagen and elastin, may gradually deteriorate with age. Inflammation (swelling) that is associated with atherosclerosis (hardening of the arteries – see below) helps to accelerate this process even in younger people.
Most aneurysms grow slowly and do not cause any symptoms, making them difficult to be found. They are usually detected during an examination for another reason. When an aneurysm is found, the doctor will monitor it closely with regular ultrasounds. If you have an aneurysm that is large or growing rapidly, you'll probably need surgery.
As an aortic aneurysm gets larger, some people may notice a pulsating feeling near the navel, pain in the abdomen or chest, or back pain. You should see your doctor if you have any of these symptoms.
The U.S. Preventive Services Task Force recommends that men ages 65 to 75 who have smoked should have a one-time ultrasound screening for abdominal aortic aneurysm. Men age 60 and older with a family history of abdominal aortic aneurysm should also consider screening.
Aortic dissection
An aortic dissection is a serious condition in which a tear develops in the inner layer of the aorta, the main blood vessel that supplies blood to the body. Blood rushes through this tear into the middle layer of the aorta, which causes the inner and middle layers to separate (dissect). If the outside aortic wall also tears, aortic dissection is often fatal. The exact cause is unknown, but risks include atherosclerosis (hardening of the arteries – see below) and high blood pressure. The most common risk group is men 60-70 years old.
Traumatic injury is a major cause of aortic dissection, especially blunt trauma to the chest. Hitting the steering wheel of a car during an accident is a common traumatic cause. Treatment usually involves surgery. When an aortic dissection is discovered early and treated quickly, you have a much better chance of surviving.
Arteriosclerosis, Atherosclerosis
Arteriosclerosis is what is commonly known as “hardening of the arteries.” Arteries are blood vessels that carry oxygen and nutrients from your heart to the rest of your body. Healthy arteries are flexible, strong and elastic. Over time, too much pressure in the arteries can make the walls thick and stiff, which makes it harder for blood to get to your organs and tissues.
Atherosclerosis is a specific type of arteriosclerosis which occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques. This is a common cause of heart attack, peripheral vascular disease (see below), and stroke.
Atherosclerosis usually causes no symptoms until middle or older age. Once the blood vessel narrowing becomes severe, it chokes off blood flow and can cause pain. A number of imaging tests such as Doppler tests may be used to see how well blood moves through your arteries.
Atherosclerosis is progressive, but it's also preventable. Risk factors include smoking, high cholesterol, high blood pressure, diabetes, abdominal obesity ("spare tire"), stress, not eating fruits and vegetables, excess alcohol intake, and not exercising regularly.
Blood Clots
When blood vessels are injured, your blood clots to repair the damage and stop the bleeding. Blood is pumped through the body by the heart, but if blood stays in one place, it may clot and cause potential life-threatening conditions. Blood clots can form in the heart, veins, arteries and other areas. Blood clots that form inside larger, deeper veins (deep vein thrombosis) may cause more widespread symptoms in the affected area, usually your leg, and can cause more-serious problems. Blood clots can also break away from a deep vein thrombosis and travel to your lungs to cause a potentially life-threatening blood clot in the lungs (pulmonary embolism).
Carotid artery disease
Carotid artery disease happens when fatty, waxy deposits called plaques (fats and cholesterol) clog your carotid arteries. Carotid arteries are a pair of blood vessels that deliver blood to your brain and head. The buildup of plaques in these arteries blocks the blood supply to your brain and increases your risk of stroke. Surgery to remove plaque buildup in carotid arteries is called carotid endarterectomy.
The first warning sign that you have this condition may be a stroke or transient ischemic attack (TIA), or “ministroke.” Treatment can involve lifestyle changes, medications, surgery, and/or a having a stent (drainage tube) inserted.
Chronic Venous Insufficiency
Chronic venous insufficiency occurs when the veins cannot pump enough oxygen-poor blood back to the heart. Chronic venous insufficiency is caused by damaged or impaired valves as a result of deep vein thrombosis or phlebitis, and most often occurs in the veins of the legs. If you have CVI, your ankles may swell and your calves may feel tight. Your legs may also feel heavy, tired, restless or achy.
Factors that can increase your risk for CVI include a family history of varicose veins, being overweight, being pregnant, not exercising enough, smoking, and standing or sitting for long periods of time. Typically, women develop this condition more than men. To confirm a diagnosis of CVI, the physician may order a duplex ultrasound test or sometimes another test called a venogram. Treatment include compression stockings, sclerotherapy, ablation, vein stripping angioplasty and stenting
Deep vein thrombosis
Deep vein thrombosis occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. You can develop deep vein thrombosis if you're sitting still for a long time, such as on a plane or in a car. However, most cases of DVT occur in sick, hospitalized patients or if you have certain medical conditions that affect how your blood clots. The symptoms you feel can depend on the location and size of your blood clot. They include swelling, tenderness, leg pain that may worsen when you walk or stand, a sensation of warmth, and skin that turns blue or red. Deep vein thrombosis is a serious condition because a blood clot in a vein can break loose, travel through your bloodstream and lodge in your lungs, blocking vital blood flow (pulmonary embolism). Your physician can usually treat DVT with medications or minimally invasive procedures. Rarely, surgery may be required.
Dissecting aneurysm (Aortic dissection)
An aneurysm is an abnormal widening or ballooning of part of an artery due to weakness in the wall of the blood vessel. An aortic dissection is a serious condition in which a tear develops in the inner layer of the aorta, the main blood vessel that supplies blood to the body. Blood rushes through this tear into the middle layer of the aorta, which causes the inner and middle layers to separate (dissect). If the outside aortic wall also tears, aortic dissection is often fatal. Anyone can develop the condition, but the most common group is men 60-70 years old.
An acute aortic dissection (less than 2 weeks) typically produces sudden onset of severe chest pain that has a tearing or ripping quality. When an aortic dissection is discovered early and treated quickly, you have a much better chance of surviving.
Aortic dissection is a medical emergency and needs immediate treatment. Treatment could be surgery or medication, depending on the location of the dissection.
Microvascular disease
Microvascular disease, also known as small vessel heart disease, occurs when the small arteries in the heart become narrow. The signs and symptoms are the same as heart disease, such as chest pain (angina). Microvascular disease is usually diagnosed after a doctor checks for blockages in the main arteries of the heart but finds little or no narrowing in the large vessels, even symptoms persist. Microvascular disease is more common in women and in people with diabetes.
Peripheral artery disease (Peripheral vascular disease)
Peripheral artery disease is a common circulatory problem and is caused by reduced blood flow to your arms and legs due to narrowed arteries. You may not feel any symptoms from peripheral artery disease at first. The most common symptom is leg pain or discomfort when walking (intermittent claudication) that goes away when you rest. Peripheral artery disease can also be a signal that you have an extensive accumulation of fatty deposits in your arteries (atherosclerosis) which might be reducing blood flow to your heart and brain, as well as your legs. If your peripheral artery disease is diagnosed early, you can successfully treat it by quitting smoking, exercising, eating a healthy diet and medications. In advanced diseases minimally invasive treatments such as angioplasty and stenting as well as open surgery are required.
Raynaud's disease
Raynaud's disease is a condition that causes some areas of your body (fingers, toes, the tip of your nose and ears) to feel numb and cool in response to cold temperatures or stress. This is because small arteries that supply blood to your skin narrow, limiting blood circulation to these areas. Women are more likely to have Raynaud’s disease, as well as people who live in colder climates. Treatment depends on its severity and whether you have any other health conditions.
Renal Artery Disease
Renal artery disease is caused by the buildup of plaque (fats and cholesterol) in the arteries that lead to the kidneys. When plaque collects in the renal arteries, this causes the arteries to stiffen and narrow, which blocks the blood flow to the kidneys. Renal artery disease most often is related to peripheral artery disease (atherosclerosis in arteries outside the heart) or coronary artery disease. Blockages in the renal arteries, known as renal artery stenosis, can cause high blood pressure, congestive heart failure, and kidney failure.
Treatment involves lifestyle changes such as weight reduction, smoking cessation, exercise and diet control as well as medications to control blood pressure, high cholesterol, and diabetes. For some patients minimally invasive procedures such as angioplasty and stenting would be required
Scleroderma
Scleroderma is a group of rare diseases that involve the hardening and tightening of the skin, blood vessels and connective tissues that provide support for your body. Localized scleroderma affects the skin. Systemic scleroderma also affects internal organs such as the heart, lungs, kidneys and digestive tract. Scleroderma affects women more often than men and most commonly occurs between the ages of 30 and 50. Scleroderma can run in families, but is not contagious.
Raynaud's disease (see above) can occur with scleroderma. The blood flow can be so restricted that permanent damage to tissues at the fingertips can cause pits or skin sores (ulcers). In some cases, gangrene and amputation may follow.
Thrombophlebitis (Phlebitis)
Thrombophlebitis (also called phlebitis) occurs when a blood clot causes swelling in one or more of your veins, usually in your legs. The affected vein is near the surface of your skin, and can get inflamed causing superficial thrombophlebitis. These types of blood clots do not usually travel to the lungs unless they move from the superficial system (just below the skin) into the deep venous system (deep vein thrombosis). However they do cause pain and need treatment. Thrombophlebitis can be caused by for a long time or lengthy bed rest.
Treatment involves self-care methods to ease pain and reduce your risk of clots, and treatments can include medications and/or surgery. Surgery may be necessary when phlebitis affects circulation and completion of everyday activities. It also may be necessary to prevent the condition from progressing into deep vein thrombosis or a pulmonary embolism
Varicose veins
Varicose veins are twisted, enlarged veins caused by the weakening of the vessel wall. Any vein may become varicose, but the ones most commonly affected are those in the legs and feet because standing and walking increase the pressure in the veins of your lower body. Spider veins are a common, mild variation of varicose veins. Symptoms include swollen legs, muscle cramps, soreness, or aching in the legs, itching around the vein, brown discoloration of the skin, and ulcers. Varicose and spider veins require medical treatment if they make walking or standing painful. Treatment options include surgery which can close or remove varicose veins.
Venous thromboembolism
Venous thromboembolism includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a common, serious disorder that affects hospitalized and nonhospital zed patients and can result in long-term complications such as chronic thromboembolic pulmonary hypertension (CTPH) and the post-thrombotic syndrome (PTS).
Common signs and symptoms of pulmonary embolism include sudden and unexplained shortness of breath, chest pain, and coughing up mucus with blood in it. Symptoms of deep vein thrombosis include pain or tenderness and swelling of extremities. Venous thromboembolism can be life-threatening, but immediate treatment with anti-clotting medications can greatly increase your chance of survival. Taking steps to prevent blood clots in your legs also can help you avoid pulmonary embolism.
Venous Disorders
The circulatory system comprises of the heart and blood vessels. Blood vessels can be either arteries or veins. Veins are flexible, hollow tubes with flaps inside called valves and return oxygen poor blood back to the heart. If the valves inside your veins become damaged as a result of venous disease, the valves may not close completely, allowing blood to leak backward or flow in both directions. Venous diseases include: blood clots, deep vein thrombosis, venous thrombosis or phlebitis, chronic venous insufficiency, varicose and spider veins, and venous ulcers.
Treatment options are specific to the type of venous disease and include both medical and surgical therapy.
Venous ulcers (Stasis leg ulcer)
A venous ulcer (sore) involves damage and loss of skin above the ankle, caused when the veins in your leg fail to return blood back to the heart. When venous blood pools in the legs while you are standing and walking, the blood pressure in your veins increases. Over a number of years, this increased pressure damages the skin and eventually an ulcer develops. Venous ulcers are common, hard to heal, and often come back.
The first sign of a venous skin ulcer is your skin turning dark red or purple, thick, dry and itchy. In the absence of any treatment, this will progress to an ulcer. An ulcer can be very painful and get infected.
Treatment is aimed at improving circulation and includes foot elevation, compression stockings, antibiotics and wound dressings.
Venous Insufficiency
Venous insufficiency is a condition where there is an impairment of the blood returning to the heart. It can occur when blood flowing forward through the veins is blocked (a blood clot), or when there is backward leakage of blood through damaged valves. The most common causes of venous insufficiency are having had blood clots and varicose veins before. Weak leg muscles that help squeeze blood forward can also cause venous insufficiency.
There are many treatment options for venous insufficiency. Prevention of venous insufficiency would be to address the risk factors. These include maintaining a healthy body weight; regular exercise; smoking cessation; protecting your legs from injury; and avoiding standing or sitting in one place or position for very long.