FAQ - peripheral vascular diseases
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What type of Doctor specializes in Peripheral Vascular Diseases?


like Deep Vein Thrombosis (sp?)
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Cardiovascular surgeons-surgery of peripheral blood vessels, i.e. those outside of the chest (usually operated on by cardiovascular surgeons) and of the central nervous system (treated by neurosurgery).
Deep venous thrombosis (DVT) is clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis. DVT is the primary cause of pulmonary embolism. DVT results from conditions that impair venous return, lead to endothelial injury or dysfunction, or cause hypercoagulability. DVT may be asymptomatic or cause pain and swelling in an extremity. Diagnosis is by history, physical examination, and duplex ultrasonography, with D-dimer or other testing as necessary. Treatment is with anticoagulants. Prognosis is generally good with prompt, adequate treatment; common long-term complications include venous insufficiency with or without postphlebitic syndrome.  (+ info)

Is there any effectilve medicine to treat peripheral vascular disease ?


Mr. Banzai has done a good job in answering the question regardig "heparin". Please tell me whether there is medicine to cure/treat peripheral vascular disease. What diseases belong to peripheral disease. Thanks.
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webmd.com or nih.gov or mayoclinic.com  (+ info)

Peripheral Vascular Diseases!?


On Oct. 4, 2006 I underwent CABG x5 bypasses. My concern is that I may have widespread atherosclerosis. For 5-8 years I have had some symptoms of PAD in my lower extremities. Including Intermitant Claudication and ED. I wonder if it may be affecting my vital organs as well. I also am concerned about Carotid Artery Disease. Are these concerns real or unnecessary? I plan to see my PCP but wanted an openion from someone in the health sciences especially with regard to vascular science. Am I too concerned? Not enough?

I also have COPD (Emphysema), Idiopathic Pulmonary Fibrosis, Sleep Apnea, Hypertension and Bipolar Disorder.
I currently take 325mg Aspirin, 500mg Nician, 10/80mg Vytorin and 160mg Triglide to help with the cholesterol. I also take 50mg Toprol-XL for the hypertension.
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You may very well have widespread blockage, but it apparently isn't severe, or your doctors would have brought it to your attention, prior to the bypass. My mom recently was showing signs of poor circulation, her little toe was turning black and was very painful. She had the angioplasty with a stent. Her blockage was in the groin area, where the arteries split into the legs. Your blockage was in the aorta, coming from the heart down across the abdomen. With your other health problems, you certainly suffer with poor circulation, and lack of oxygen in the blood. You should be concerned with your health, but my feeling is this, you made it throught a serious bypass surgery, so your health is actually pretty good overall. Vascular surgeons are very well educated, I feel your doctor is your best advice giver. Be sure to bring your concerns to the table when you see the doc. Make a list if necessary, but make sure you understand what is being said, ask more questions if you don't. If you smoke, you must stop. My mom refuses to, and her health is deteriorating because of this. She simply doesn't believe that cigarettes can cause her severe health problems, she always blames something else. Good luck to you, keep your appt.  (+ info)

Could you please tell me the difference between Chronic Venous Insufficiency and Peripheral Vascular Disease?


I was told yesterday by my doctor that I have Chronic Venous Insufficiency which I think I understand. However, I also came across PVD and then became confused. Are they the same?
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chronic venous insufficiency is when your veins cant pump the blood back to your heart (so it pools in your legs).

peripheral vascular disease (which common in diabetics or people with high cholesterol) is a problem with the arteries (not veins) that are clogged up (from atherosclerosis) and thus cannot deliver enough blood to the peripheral limbs (such as legs) resulting in symptoms of the pain (intermittent claudication or pain in calves after exertion) or ulcers.  (+ info)

can aspirn disolve blood clots? if i really have peripheral vascular disease?


been taking aspirn 325 ( coated ) for 3 days & im pain free after crying for 3 days, & wanted to know can aspirn disolve blood clots on its own? when its ONLY possible i may have minor periphrenal vasculer disease? ive had severe leg cramps & count get up the past month & started aspirn threapy for the last few days? any advice? hints? or tips? i wont get mad.
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The answer is no. Aspirin helps to make the blood "thinner" so that it travels more easily. If you are taking Aspirin and it helps, continue to take it! Glad you are pain free.  (+ info)

What happens with Peripheral vascular disease ?


My partner has had pains in his legs for over a year and finally went for a test and was diagnosed with PVD,my partner said that the pulse in his leg was so weak that had a hard time finding it.What is going to happen to him next ? He has already had a heart attack at christmas so I am very worried.
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Does your partner smoke? Or have diabetes? If so, he should attempt to quit smoking right away because this will help the condition. If he has diabetes and it is not well controlled he should make sure to keep it under control, because this will help as well.

PVD can go on to cause numbness and tingling in the legs, or burning and aching. He should ask his doctor if there are any underlying conditions that can be treated to ease the PVD. Also, if he is already having numbness or loss of sensation in his legs he, or you, should be sure to check his legs periodically for any sores or injuries that he may have sustained without feeling them.

Good luck.  (+ info)

Can a broken ankle be a contributing factor to peripheral vascular disease?


It is very possible it could cause vascular comprimise distal to the fracture, but seems an unlikley factor in systemic peripheral vascular disease or in your other limbs. Please check with your doctor to see how you individual situation could affect any answer to this question.  (+ info)

What is Peripheral vascular resistance?


I am a nursing student and currently studying OB. In our lecture the teacher stated that the peripheral vascular resistance decreases....so does this mean that blood flows more easily through the body?
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Treatment for vascular disease has two major goals. The first is to treat blockages that are causing symptoms, such as leg pain, so that you can resume physical activities. The second is to stop the progression of vascular disease to reduce your risk of heart attack and stroke. Many people can accomplish these goals with lifestyle changes such as exercise and improved diet or medication to help prevent blood clotting and improve symptoms. The NSMC Vascular Center incorporates lifestyle and wellness programs to help you prevent complications of vascular disease and improve quality of life.  (+ info)

i have been told to see a vascular specialist for my peripheral artery disease and also have to have?


an angiogram. how risky is this if at all?
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When you see the vascular specialist you can ask them. The risk varies from person to person and depends on a lot of different things. Your age, your weight, your family history, the results of certain tests you may have all ready had, and tests you may need to have done. My husband is 70, and his went fine.
It's probably riskier NOT to have the tests done. If you already have a blockage, you could have a stroke or a heart attack any time.
An angiogram will let you know if you have any blockages, and if anything can be done. IF you don't have a blockage then everything can be treated with medication and diet changes. Your doctor can explain all of this to you. Please don't be afraid of the test, knowledge is always good.  (+ info)

I have severe peripheral vascular disease. My dr is trying his best to prevent having to take away my limbs.?


I know have approx. 15 stents in my legs and 10 in my heart area. Will my body allow me to continue to fight this battle or will there be a time when I just have too many stents?

P.S. Thanks to Dr Samuel Demaio for helping me fight this battle.
Thank you for your nice words.
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I truly empathize with you. Having said that, let me give you the following info:


In most cases, the presence of PVD is a sign of systemic atherosclerosis, which puts these patients at high risk of stroke, myocardial infarction, and cardiovascular death. Risk factors for PVD include smoking, hypertension, hyperlipidemia, diabetes, family history of cardiac or vascular disease, obesity, and sedentary lifestyle


Conservative treatment options, including cessation of tobacco use, exercise programs, and modifications in lipoprotein and cholesterol abnormalities, are the first line of defense against PVD.


Have you and your Dr consider other options than amputation?


1) Angioplasty (Percutaneous Transluminal Angioplasty)

TABLE 1

Angioplasty vs. Bypass Surgery
for PVD of the Lower Extremities

Angioplasty

Advantages
Offers faster recovery
Requires shorter hospital stay
Requires no general anesthesia
Maintains all options for extremity revascularization
Allows for preservation of the saphenous veins for
future use (for extremity or coronary artery bypass)
May be repeated if necessary
May be combined with surgery to improve inflow or
outflow of surgically placed grafts

Disadvantages

Lower primary patency rates
Reinterventions due to restenosis may be necessary
Of limited use in the presence of multiple-level stenoses
Cost-benefit ratio for severe advanced PVD is debatable


2) Coronary Artery Bypass surgery (CABG)

Advantages

Considered the gold standard
Has good long-term patency
May be preferable to treat multiple stenoses if venous conduit available

Disadvantages

A higher rate of morbidity
Potential systemic complications
Typically requires general anesthesia
Requires harvesting of saphenous veins and
upper extremity veins, precluding their use
for coronary artery bypass


3) Antiplatelet/antithrombotic therapy also may be considered for use in these patients. Studies have shown that aspirin therapy may modify the natural history of chronic lower extremity PVD. It also has been suggested that use of aspirin may prevent death and disability from stroke and myocardial infarction secondary to underlying disseminated atherosclerosis.

I guess your Dr might have used the drug Trental among others already.


4) Percutaneous Revascularization -

Surgical bypass of severely occluded vessels has been considered the gold standard for use in symptomatic patients who do not respond to more conservative treatments.



Rapid advances in percutaneous revascularization techniques and equipment have significantly changed the patterns of vascular reconstruction, particularly when lifestyle modifications and drug therapies fai


For purposes of revascularization, PVD is considered in terms of inflow (aortoiliac) and outflow (infrainguinal) occlusive disease. In both cases, surgical revascularization represents the gold standard against which the results of percutaneous revascularization with angioplasty and stents are compared. Increasingly, combined surgical bypass and percutaneous endovascular treatment by the vascular/interventional radiologist, vascular surgeon, or interventional cardiologist are being used to optimize patient outcome while minimizing morbidity.

AORTIC REVASCULARIZATION

The iliac arteries are technically among the easiest vessels to approach percutaneously and are the largest peripheral lower extremity vessels with the highest flow rates. These factors optimize the outcome of percutaneous transluminal angioplasty (PTCA) and stenting (Table 2). Surgical bypass has a durable high rate of patency, reported as 93 percent at 42 months in a recent study,but it is a major surgical procedure with potential for systemic complications in patients with preexisting significant comorbid conditions

Table 2

Characteristics of Best Candidates
for Angioplasty

Stenosis, rather than occlusion
Short-segment disease
Noncalcified lesions
Concentric stenoses
Large-vessel involvement
No coronary comorbidity or treated coronary disease
No diabetes
Claudication
Normal renal function
Good run-off (i.e., patent vessels distal to treated
lesion)



NOTE: Patients who have had their saphenous veins harvested
for coronary artery bypass may be better candidates for
percutaneous transluminal angioplasty than for synthetic
bypass grafting, depending on the lesion and location


You might be interested in the info below :


Directory of physicians who perform endovascular techniques, patient information about PVD and details about the Legs for Life National Screening Week for PVD Leg Pain are available through the Society of Cardiovascular & Interventional Radiology, 10201 Lee Hwy., Suite 500, Fairfax, VA 22030; telephone, 800-488-7284; Web site, http://www.scvir.org


Are you a good candiate for amputation? Remember, diabetics do not heal very well.
You are indeed faced with an arduous life decision?

There are a lot of questions and answers you have to consider.:

Ischemia to lower limbs would eventually lead to gangrene and thus amputation. How long can you tolerate the pain and discomfort from claudication ? How many more stents can your extremities take? How long will this present stent remain patent? Is there any alternative solution to my problem aside from limb loss?


Of course, it's easier for me to say; because I'm not in your shoes. But if I were you, I'll take my chances with every possible option short of amputation. No matter what they say about being wheelchair -bound; I don't think you'll ever get adjusted to that kind of substandard life. You'll be so devastated by the loss of your integrity and dignity as a vital individual.

My prayers are with you!!! Pls post again to let us know about your decision.  (+ info)

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