Conditions We Treat
Angiology and vascular surgery is a medical specialty dedicated to studying and treating diseases of the circulatory system. It is a medical-surgical specialty, meaning it treats diseases with both medication and surgery when the patient needs it.
All diseases affecting the veins and arteries, except for the arteries of the heart and those of the skull, which are treated by cardiologists and neurosurgeons, respectively.
The most common conditions are: venous diseases, varicose veins of all degrees, venous thromboembolic disease, including deep vein thrombosis, pulmonary thromboembolism and post-thrombotic syndrome, varicose ulcers, venous injuries caused by weapons, surgical complications, hemangiomas and venous malformations.
Angiology and Vascular Surgery
- What conditions does an angiologist and vascular surgeon treat?
- What does an angiologist and vascular surgeon treat?
Arterial Diseases: Chronic arterial insufficiency, acute arterial insufficiency, arterial thromboembolism, arterial aneurysms of the aorta and peripheral arteries, vasospastic diseases such as Raynaud’s disease, Buerger’s disease, etc. Arterial injuries caused by weapons or surgical complications, carotid body tumors (glomus tumors or paragangliomas), and carotid artery disease.
Other conditions: Diabetic foot, chronic wounds, lymphedema.
Patients with renal insufficiency who need vascular access for hemodialysis, such as an arteriovenous fistula or placement of a central venous catheter, and cancer patients who need central venous access, such as an implanted port catheter for chemotherapy.
Diabetic foot is a devastating complication of diabetes mellitus, caused by nerve degeneration, blood vessel occlusion associated with infection, and gangrene.
Diabetes mellitus is the leading cause of lower-limb loss. Eighty percent of amputations began with an unnoticed injury, and in most cases they could have been prevented. If you have diabetes and develop a foot injury, time is of the essence—seek care as soon as possible and avoid life-threatening complications.
Diabetic foot
To treat any foot injury in patients with diabetes, the first priority is to ensure adequate circulation. Without circulation, any treatment will be unsuccessful. Before undergoing amputation, every patient with diabetes should be evaluated by an angiologist and vascular surgeon.
Veins are the blood vessels that carry blood back to the heart after supplying the body's organs. From the heart, blood travels to the lungs to be oxygenated and then sent throughout the body again.
This cycle, which repeats continuously, must overcome various obstacles—especially the blood returning from the feet to the heart. The first obstacle is gravity, and the second is hydrostatic pressure (that is, the blood below must push the blood above it). For blood to return properly, the walls and valves of the veins must remain intact. When any of these mechanisms fails, blood has difficulty returning to the heart and may pool in the veins, causing dilation, twisting (a serpentine appearance of the veins), edema, or swelling.
Chronic Venous Disease or Varicose Veins
In its early stages, it causes only cosmetic concerns due to the appearance of varicose veins, creating an unattractive appearance in the legs. Later, pain, cramps, heaviness, and fatigue may develop, and in advanced stages, complications such as lipodermatosclerosis (hardened, discolored skin), bleeding (varicose vein hemorrhage), clot formation (varicose vein thrombosis), and ulcers may occur. These ulcers can be disabling and may also affect the patient’s family, social, and emotional life. This condition is commonly known as chronic venous disease, varicose syndrome, or varicose veins. Its causes include: Predisposing factors: family history and deep vein thrombosis. Triggering factors: standing or sitting without moving for long periods, multiple pregnancies, blows or injuries, high doses of female hormones (estrogens), flat feet, and exposure to high temperatures.
Aggravating factors: Obesity, a sedentary lifestyle, and diabetes.
Laser Varicose Vein Surgery
Currently, more than 90% of varicose veins can be eliminated in the vast majority of patients who have them. Request an evaluation consultation with us and we will help you resolve the problem.
What are the causes and symptoms of thrombosis?
For blood to perform its function, it must remain in a liquid state, which requires a balance between procoagulant and anticoagulant factors. When this balance is disrupted, it can result in thrombosis (thrombophilia) or the opposite, bleeding (hemophilia).
90% of DVT cases occur in the lower extremities, more frequently on the left side, and the signs and symptoms are:
Pain, swelling, increased circumference in the affected limb, changes in color at the site of the thrombosis, and edema.
Deep Vein Thrombosis
Everyone is at risk of developing thrombosis, but if you have one or more of the following risk factors, your chances of developing it increase:
*Family history of thrombosis.
*Family history of thrombophilia.
*Having a collagen disease (rheumatoid arthritis, scleroderma, lupus, among others).
*Pregnancy (not all pregnant women experience it).
*Have cancer.
*Obesity.
*Age over 40 (in certain circumstances).
*Orthopedic surgery (hip or knee).
*Prolonged travel (more than 4 hours or over 5000 km) by any means of transportation. (Economy class syndrome).
*Prolonged immobility (being bedridden for a long time).
*Multiple fractures.
*Immobilization (use of a splint or cast).
*Central venous catheter.
*If you use oral contraceptives or hormone replacement therapy.
*If you have already had thrombosis, it can happen again.
Diabetic Neuropathy
Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood glucose levels can damage nerves throughout the body. Diabetic neuropathy most often affects the nerves in the legs and feet.
Depending on which nerves are affected, symptoms of diabetic neuropathy include pain and numbness in the legs, feet, and hands. It can also cause problems with the digestive system, urinary tract, blood vessels, and heart. For some people, the symptoms are mild. However, in others, diabetic neuropathy can be quite painful and disabling.
Peripheral neuropathy
This type of neuropathy may also be called distal symmetric peripheral neuropathy. It is the most common type of diabetic neuropathy. It first affects the feet and legs, followed by the hands and arms. Signs and symptoms of peripheral neuropathy generally worsen at night. They include the following:
- Numbness and reduced ability to feel pain or sense changes in temperature
- Tingling or burning sensation
- Cramps or stabbing pains
- Muscle weakness
- Extreme sensitivity to touch (for some people, even contact with the sheets can be painful)
- Serious foot problems, such as ulcers, infections, and damage to the bones and joints
When should you see a doctor?
Call your healthcare provider to make an appointment in the following cases:
- Do you have a cut or infected sore on your foot that will not heal?
- You have burning, tingling, weakness, or pain in your hands or feet that interferes with your daily activities or sleep
- You notice changes in digestion, urination, or sexual activity
- You experience dizziness and fainting
Signs and symptoms of lymphedema include the following:
- Swelling of all or part of the arm or leg, including the toes and fingers
- A feeling of heaviness or tightness
- Limited range of motion
- Recurrent infections
- Hardening and thickening of the skin (fibrosis)
When you should see a doctor
Make a medical appointment with your doctor if you notice persistent swelling in your arms or legs. If you have already been diagnosed with lymphedema, see your doctor if there is a sudden and significant increase in the size of the affected limb.
Lymphedema
Complications
Complications of lymphedema may include:
- Skin infections (cellulitis). Trapped fluid creates a favorable environment for germs to grow, and even the smallest injury to the arm or leg can provide an entry point for infection. The affected skin appears swollen and red, and is usually painful to the touch and feels warm. Your doctor may prescribe antibiotics for you to keep on hand so you can start taking them right away.
- Septicemia. Untreated cellulitis can spread to the bloodstream and trigger septicemia, a life-threatening condition that occurs when the body's response to an infection damages its own tissues. Septicemia requires emergency medical treatment.
- Drainage through the skin. With severe swelling, lymphatic fluid can drain through small breaks in the skin or cause blisters.
- Skin changes. In some people with very severe lymphedema, the skin of the affected limb may thicken and harden, taking on the appearance of elephant skin.
- Cancer. A rare form of soft-tissue cancer can develop as a result of the most severe cases of untreated lymphedema.
Vascular Access for Hemodialysis
Dialysis and hemodialysis
Dialysis is used to treat end-stage kidney failure. This procedure removes waste from the blood when the kidneys can no longer do their job.
There are different types of kidney dialysis. This practice focuses on hemodialysis.
What is vascular access?
A vascular access is an opening made in the skin and blood vessel during a short procedure. When you undergo dialysis, your blood flows through the access to the hemodialysis machine. Once your blood has been filtered by the machine, it flows back into your body through the access.
What is hemodialysis?
The main function of your kidneys is to remove toxins and excess fluid from your blood. If waste products build up in the body, it can be dangerous and may even cause death.
Hemodialysis can:
- Remove excess salt, water, and waste products so they do not build up in your body
- Maintain safe levels of minerals and vitamins in your body
- Help control blood pressure
- Help produce red blood cells
When to Call the Doctor
- Bleeding from the vascular access site
- Signs of infection, such as redness, swelling, pain, tenderness, warmth, or pus around the site
- A fever above 100.3°F (38.0°C)
- The flow (thrill) in the graft or fistula decreases or cannot be felt at all
- The arm where the catheter was inserted swells, and the hand on that side feels cold
- Your hand becomes cold, numb or weak
Risks and Complications
As with any procedure, peripheral vascular intervention involves certain risks and complications, which may include:
- Allergic reaction to the contrast medium.
- Bleeding or infection at the puncture site
- Recurrent narrowing of the artery.
Peripheral Vascular Catheterization
When patients have hardening of the arteries, or atherosclerosis, their arteries are partially blocked by a substance called plaque. When these blockages occur in the legs or arms, they are called peripheral artery disease.
In most patients, fluid and intravenous medication needs can be met with a percutaneous peripheral venous catheter. If blind percutaneous placement is difficult, ultrasound guidance generally achieves successful insertion. On rare occasions, a venous cutdown may be used when percutaneous catheter insertion is not feasible. Typical venous cannulation sites are the cephalic vein in the arm and the saphenous vein at the ankle. However, venous cutdown is rarely necessary due to the widespread use of peripherally inserted central catheters (PICCs) and intraosseous access in adults and children.
Cardiovascular diseases are the third leading cause of death in Mexico.
Among the most common conditions are chronic venous disease, known as varicose veins, varicose ulcers, deep vein thrombosis, chronic arterial insufficiency, acute arterial insufficiency, and diabetic foot.