Our veins and arteries (blood vessels), but also the lymphatic vessels, are a network of vessels that distributes throughout the body oxygen and other nutrients essential to the functioning of our organs and tissues. This network also drains the body functioning waste products to be eliminated. If these vessels become ill, its functions are compromised. Vessel disorders can only slightly affect everyday life or create high degree of disability situations. Currently all of us - the general population and health professionals - are increasingly aware of the impact that vessel diseases, or vascular diseases, can have on quality of life. These diseases are treated by the medical specialty Angiology and Vascular Surgery, often known only as Vascular Surgery. When to suspect a vascular disease Suspected vessel disease is usually related to the presence of symptoms. The signs and symptoms of vascular disease depend on the vessels that are affected. In the same person, more than one type of vessel and in more than one location may be affected. Therefore, the signs and symptoms may be more or less typical of illness. When you have symptoms that may be related to vessel disease, it is essential to seek specialized medical care. What are the most common vessel diseases and which vessels affect them? The most common vascular diseases are: Chronic venous disease, which is a disease of the veins; Peripheral arterial disease, which is a disease of the arteries. Chronic venous disease The veins have valves inside that help the blood to flow in the right direction. Chronic venous disease is due to the progressive development of an insufficiency of these valves and the consequent dilation of the walls of the veins due to the blood that accumulates. The prevalence of chronic venous disease is higher in women and increases with age. For example, a prevalence of 20% at 30-40 years old can increase to values above 50% in the age group of 70 years old. Most frequent symptoms, signs, and findings in chronic venous disease Typical symptoms are, for example, weight, pressure, tiredness, edema (swelling) and / or itching in the legs, which worsen with the standing position for prolonged periods. These symptoms are easily related to chronic venous disease, but they can also have several origins. Atypical symptoms, such as pain that is sometimes disproportionate to other findings, reinforce the importance of seeking a specialist. Complaints directly related to varicose veins, such as local pain, inflammation and / or thrombotic complications, or even aesthetic issues. In the most advanced stages of the disease there may be skin pigmentation, trophic (structural) changes in the skin or ulcerated lesions. Isolated aesthetic complaints, which are common and equally valid, have several options for its treatment. Peripheral arterial disease Peripheral arterial disease is due to obstruction of the arteries and is, in most cases, related to atherosclerosis. On average, it affects about 3% -10% of the population, but increases to 15%-20% in people over 70 years old. Peripheral arterial disease is a risk factor for cardiovascular disease. Most frequent symptoms, signs and findings in peripheral arterial disease Intermittent lameness, with a typical pain triggered by walking, which arises after always walking the same distance, and which relieves with rest. The pain usually involves the region of calf muscles and can also reach the thigh and / or buttock. There are also cases where the pain is atypical or where the patient has no pain, because he does not usually walk long enough to trigger it. It is essential that the specialist look closely for these situations to be properly identified. In more advanced cases, there may be pain at rest, triggered by elevation of the limb and which improves when it is pending. The most characteristic complaint is pain that disturbs sleep. Ulcers and trophic lesions, preferentially affecting the foot, are also more characteristic of the advanced stages of the disease. At these stages, the viability of the member may be compromised. When to go to a vascular surgery appointment Whenever someone has symptoms that may be related to vascular problems, there may be benefit from observation by a vascular surgeon. An urgent consultation is rarely required for chronic venous disease, except for thrombotic complications or the appearance of leg ulcers. However, there is also no benefit associated with "letting go", since vascular diseases benefit greatly from prevention and early treatment. Peripheral arterial disease is indicated for urgent interventional treatment in the context of pain at rest and the appearance of ulcers or foot injuries. Intermittent claudication can usually be monitored in consultation. Often it is other physicians, for example family doctors, who advise for the need of a vascular surgery appointment. When vascular diseases are suspected, it is very important that this referral is as early as possible. The complete approach of the vascular surgeon will be able to identify structural changes in the vessels that are not immediately apparent, and he will define the most appropriate treatment after: Vascular structural study, usually using an eco-Doppler exam; Correlation between the patient complaints and the medical examination findings; Adequacy of treatment to the stage of the disease and to the specificity and expectations of the patient. Only then will it be possible to obtain an effective, long-lasting result that corresponds to the best that the vascular health treatment can offer. References: Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, TASC II Working Group. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 2007;45:S5-67. Pannier F, Rabe E. The relevance of the natural history of varicose veins and refunded care. Phlebology 2012;27:S23-6. Autor: Ricardo D’Almeida Gouveia The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
