currently browsing September 2015

What is the Difference Between Venous Disease and Peripheral Artery Disease?

Peripheral Arterial Disease (PAD) and venous disease are two very distinct disease states with different causes, symptoms and care pathways. Depending on the patients’ conditions, there may be some similarities in the treatment of the two diseases. Conditions and Causes Peripheral arterial disease, or PAD, is a condition where the muscles of the legs suffer from a restricted blood supply[1]. PAD is caused by plaque; fatty materials and cholesterol that build up inside the arteries. This plaque will begin to narrow and block the arteries, restricting the flow of oxygen and other nutrients to the lower limbs. PAD can also be called peripheral vascular disease, or PVD, and is a common form of cardiovascular disease[1]. People are more at risk of PAD as they age. It is believed that there are over 8 million PAD sufferers in the US alone and millions more around the world. It is more common in men than women and in people over the age of 50. Hispanics and African Americans are also particularly at risk. Contributing factors include smoking, diabetes, high cholesterol and high blood pressure. Venous disease is a condition that, generally, affects the veins in the lower extremities[2]. It arises from two conditions, venous reflux and/or obstruction. Reflux is when the walls of the veins in the legs deteriorate and the small valves that allow blood to return to the heart become defective. Obstruction, commonly referred to as Venous Outflow Obstruction, is when the blood flow in the vein becomes restricted or blocked. A blood clot, resulting from an injury or surgery, may be responsible for blockage. Other factors contributing to reflux and obstruction include hormones, pregnancy, excess weight, smoking or sitting or standing for too long. Both of these conditions allow blood to pool, and this may create additional pressure in the veins, leading to further damage and healthcare problems for the patient. Symptoms Many PAD sufferers have no symptoms... Read more

What are Varicose Veins and are they Dangerous?

Varicose veins are swollen and twisted veins that are highly noticeable beneath the skin1. In most cases, they have a blue or purplish color to them. Varicose veins can affect any part of the body, but they most commonly affect the leg and feet area1. Though the body’s system of veins is complex, the simple function of them is simply to return deoxygenated blood from the organs of the body back to the heart and lungs2. Understanding Varicose Veins In most cases, veins perform as expected; but just like anything else, they can become diseased and damaged. Varicose veins are a direct effect of damaged valves and/or blocked veins1. As mentioned earlier, veins carry blood back to the heart2. They achieve this through the function of a series of one-way valves1. As these valves begin to weaken and fail, the direct result is a backward flow of blood. The veins may also become blocked or occluded, restricting the flow of blood back to the heart. This backward flow and/or blockage causes an increase in the pressure in the veins (venous hypertension). This increased blood pressure results in the bulging or swelling of the veins in this area, and since the blood is deoxygenated, the veins have a bluish or purplish color. There are many theories behind what actually causes the onset of varicose veins. Oftentimes, it happens as people age and, just as other functions and systems of the body begin to weaken, so does the function of the venous valves and elasticity in the veins. However, other factors such as pregnancy, genetics and even smoking and obesity can play a part behind the cause of varicose veins1. Dangers and Treatment Options For most people, besides being self-conscious about the appearance of the varicose veins, they will have no additional symptoms or consequences to their health3. However, others may not be as lucky, and because there are dangerous complications... Read more

What is Iliac Vein Compression Syndrome?

Iliac Vein Compression Syndrome, also called May-Thurner Syndrome, is a natural condition that arises when the left common iliac vein is compressed between the right common iliac artery and the spine1. This leads to symptoms ranging from mild to serious, including leg pain, swelling, discoloration and iliofemoral vein DVT (deep vein thrombosis). While the syndrome represents less than 5 percent of the currently diagnosed venous disorders, increased awareness and better diagnostic options are resulting in its more frequent identification as an underlying factor in venous disease. It is characteristically more common in women than men, and usually between the ages of 20 and 50 years old. Diagnosis The best way to identify the disorder is through intravascular ultrasound, but other tests, such as venous and interstitial pressure measurement, duplex ultrasound, venography and plethysmography, can aid in diagnosis2. These diagnostic tests of the deep pelvic veins help physicians identify iliac vein compression syndrome. Patients that present with leg pain, swelling or discoloration should be tested, as well as those with varicose veins. If iliac vein compression syndrome underlies varicose veins, it should be treated first. Patients that have blood clots in the leg, or a history of such, should be tested for iliac vein compression syndrome. Proper diagnosis of this syndrome is important in helping physicians and patients selecting treatment options and preventing further, more debilitating, complications of venous disease. Treatment Some cases of iliac vein compression syndrome may require treatment, which will vary depending on the nature and severity of the patient’s symptoms. Treatments for minor cases include anti-clotting medication (anticoagulation) and compression therapy, such as compression stockings. If blood clots are present, thrombolytic therapy, which is the use of drugs to dissolve blood clots, may be necessary. In cases where the compression of the vein is serious, balloon angioplasty and stenting of the vein may be required3. In all cases, if you suffer any of the symptoms discussed,... Read more

What are Treatment Options for Post-Thrombotic Syndrome?

Post-thrombotic syndrome (PTS) is a common complication that strikes patients who have had a deep vein thrombosis (DVT). PTS affects as many as 20-50 percent of DVT patients, and symptoms may not appear until years after a DVT. It causes leg pain, swelling, heaviness, itching or tingling, and discoloration, which may also lead to diminished quality of life1, 2. If untreated, the blood clot present with DVT can cause inflammation and damage to the valves which allow the blood to return to the heart. The obstruction and/or damaged valves ultimately diminish circulation and if left untreated, can eventually lead to more severe complications, such as venous ulcers. A venous ulcer is an open, shallow wound that appears on the lower leg, just above the ankle and below the calf. It is these ulcers that make treatment of PTS so vital. Venous ulcers are time-consuming and costly to treat, consuming approximately 2% of healthcare spending in the United States. Because a large percentage of PTS patients develop complications, early diagnosis and treatment is imperative. Traditional Treatments Typically, compression stockings are the first step in the care pathway3. They offer varying levels of support and should be fitted by a healthcare professional3. They are worn during the day and may be removed at night. Patients are generally placed on anticoagulation therapy (blood thinners) to prevent the recurrence of clots. Endovascular Therapy Unfortunately, PTS patients may have an obstruction of one or more of the major veins returning blood to the heart. If this is the case, balloon angioplasty and venous stents are required to open the veins and allow adequate flow of the blood. Venous stenting is minimally invasive and safe, providing significant relief from symptoms4. This procedure has provided physicians with an alternative to bypass surgery, which is open surgery and produced results no better than angioplasty and stenting. For patients whose disease has progressed to the stage of venous... Read more

What is Postthrombotic Syndrome?

Affecting up to 20-50 percent of people who experience complications from deep vein thrombosis (DVT)1, Postthrombotic Syndrome (PTS) can have a major effect on an individual’s daily productivity. The syndrome’s presentation, symptoms, causes and treatment options are described as follows. Description of Syndrome Most commonly observed in the legs, PTS is defined as a group of symptoms that occur following a diagnosis of deep vein thrombosis (DVT), or the presence of a blood clot in a vein not located at the superficial surface of the body. Anti-coagulation drugs, walking regimens and compression therapies can help to manage DVTs, but in situations where these methods are not fully effective, PTS may develop and necessitate further interventions2. Associated Symptoms The symptoms of postthrombotic syndrome are often more pronounced when a patient is in motion, and less pronounced when a patient is at rest or with the affected limb in an elevated position. Appearance wise, these symptoms may present as one or more of the following: red or brown pigmentation of the skin, swelling of the limb, venous leg ulcers, thickening of limb tissue and varicose veins. The patient may experience physical symptoms such as cramping or more intense pain, tingling, itching and a feeling of heaviness. Related Causes DVT is the preliminary condition associated with PTS. Those who are diagnosed with the former condition are thought to have a greater chance of developing the latter condition if several factors are present. These include venous hypertension, damage or inflammation of the venous valves and a recurrence of deep-vein thrombosis in the same limb where the first occurrence was found. Studies have examined several additional factors that can put people at elevated risk for developing PTS. Obesity, advanced age, thrombosis of the iliac or femoral vein, persistent recurrence of symptoms within one month of a deep vein thrombosis diagnosis, the presence of certain biomarkers and blood clotting disorders are included among these factors3.... Read more