When it comes to cardiac health, vascular diseases are probably not the first thing that comes to mind. However, vascular diseases like peripheral artery disease (PAD) and venous insufficiency are common and sometimes overlooked. Dr. Yazan Ghosheh, and Dr. Yalcin Hacioglu answer questions about vascular disease. 

PAD with Dr. Yazan Ghosheh

What is peripheral artery disease (PAD)?
PAD is the narrowing of the arteries to the legs, stomach, arms and head. It is most common in the arteries of the legs and pelvis. PAD can result from a condition known
as atherosclerosis, where a waxy substance called plaque forms inside the arteries.
When enough plaque builds up on the inside of an artery, the artery becomes clogged, and blood flow is slowed or stopped. This can cause pain and cramping in the legs. 
How do you diagnose and treat PAD?
PAD diagnosis starts with knowing the patient’s history and examining them. If we determine a patient may have PAD, we can do a simple test comparing the patient’s blood pressure in their ankle to the blood pressure in their arms. Depending on the results of that test, we may also do a Doppler ultrasound or use other imaging techniques. Once we have a diagnosis, the treatment plan can include lifestyle changes, medication or minimally invasive procedures such as angioplasty or stent placement.
What causes PAD?
PAD is mostly caused by plaque buildup in the arteries, which narrows them and restricts blood flow. 
How can I reduce my risk of developing PAD?
Some risk factors are not controllable, including aging and a personal or family history of PAD, cardiovascular disease or stroke. However, risk factors that you can control include smoking, diabetes, being overweight or obese, high cholesterol, high blood pressure and low physical activity.

Venous Insufficiency with Dr. Yalcin Hacioglu

How would you describe venous insufficiency and its symptoms?
Venous insufficiency is the failure of veins to maintain unidirectional (or one-way) flow
of blood from the legs back to the heart due to dysfunctional vein valves on major superficial or deep leg veins. This can cause a variety of symptoms, including swelling or discomfort in the legs, restless legs, itching, eczema, bulging varicose veins, redness or
hyperpigmentation of skin, thickening and stiffening of the skin, deformed toe nails, cellulitis and skin ulcers.
How do you treat venous insufficiency?
For patients who may have venous insufficiency, we perform a Doppler ultrasound study
that helps us determine what path treatment will take. Some patients are treated with minimally invasive techniques, such as compression stockings, lifestyle modifications and exercises such as leg elevation or calf pumping. For more serious cases, procedures including sclerotherapy—a common treatment for varicose veins—and radiofrequency ablations are available. 
What causes venous insufficiency?
Venous insufficiency can be caused by any condition that disrupts normal vein valve function. This can include trauma, inflammation, obstruction, genetic predisposition and other conditions that can cause increased central venous pressure, such as heart
failure or pulmonary hypertension. 
How can venous insufficiency be prevented?
Like many cardiovascular conditions, one important way to prevent venous insufficiency is maintaining a healthy body weight. You can also help prevent it by avoiding prolonged standing, establishing regular walking exercises, and being aware of its symptoms so you can catch it and treat it early.

Learn more:

• Peripheral Artery Disease (PAD)

• Venous Insufficiency