Vascular Diseases: Causes, Diagnosis, Symptoms, and Treatment

The severe symptoms of these diseases are primarily caused by deposits (plaques) within the arterial systems. In most cases, these are

• blood lipids
• cholesterol
• clots
• sugar
• calcium

Plaques form on the vessel wall following severe inflammation. However, this inflammation can be caused by various factors. Depending on the affected region, different vascular diseases may develop.

On the left is a healthy blood vessel; on the right is a blood vessel narrowed by plaques (shown here using a coronary artery as an example)

Numerous risk factors contribute to plaque formation and the development of vascular disease. Currently, excessive consumption of high-fat and high-cholesterol foods is still considered one of the main causes of lipid deposits in the vessel walls. Furthermore, being overweight and having high blood pressure also increase the risk of developing the disease.

In addition, patients with elevated blood sugar levels (diabetics) are particularly at risk of developing vascular disease. This also applies to smokers and people who consume excessive amounts of alcohol.

The various forms of these diseases are mainly divided into two categories. These are

• diseases of the arterial system (arteries) and
• diseases of the drainage system (veins and lymphatic vessels).

From this, the three main forms of vascular disease are derived: these can affect either the arteries, the veins, or the lymphatic system.

Arterial vascular disease is most commonly known as atherosclerosis. This is characterized by the formation of narrowings and blockages within the arteries.

Venous vascular diseases, on the other hand, include not only varicose veins but also venous insufficiency and venous thrombosis.

When it comes to diseases of the lymphatic system, a distinction is primarily made between primary and secondary lymphedema. These are visible and palpable accumulations of fluid that can no longer be drained.

Varicose veins © zlikovec / Fotolia

Many vascular diseases can be successfully treated without surgery. However, the treatment method used depends heavily on the current stage of the disease. Arterial circulatory disorders are generally treated with medications that dilate the blood vessels. This increases blood flow velocity and can improve blood supply to the tissues. In addition to the balloon catheter procedure, surgery (bypass graft) may also be necessary.

Medical treatment of these various conditions is necessary in every case, as the affected vessels can become completely blocked as a result of plaque buildup. If this occurs, it usually results in permanent damage to the affected organs and tissue cells, including conditions such as heart attack or stroke.

For venous problems, compression stockings or blood-thinning medication (e.g., Marcumar®) may be necessary. In some cases, sclerotherapy is successfully used to alleviate symptoms in the early stages of the disease. However, in cases of severe swelling and edema, surgical intervention is usually necessary.

This involves removing varicose veins, either by applying heat delivered from the inside via a catheter, which causes the vein wall to seal shut. These procedures are performed without an incision (minimally invasive); the catheters are inserted through the skin. First introduced in the United States, these endovenous (performed from within the vein) procedures have also been increasingly performed in Europe since 1998. Traditional methods involve the removal of varicose veins via an incision in the groin, the back of the knee, or the lower leg.

In most cases, however, vascular diseases can be effectively prevented. Without additional risk factors, these diseases occur only very rarely. By avoiding risk factors, you can significantly reduce your risk of developing these conditions.

People at risk should therefore completely avoid smoking and drinking alcohol. In addition, a healthy diet and regular exercise are of crucial importance. You should also avoid stressful situations as much as possible to minimize your risk of developing these conditions.

For venous diseases, wearing compression stockings is recommended during high-risk situations (such as long flights or car trips).

What are vascular diseases, and what conditions do they include?
Vascular diseases are among the most common conditions affecting the blood vessels and involve arteries, veins, capillaries, and the lymphatic system. These include, among others, peripheral arterial disease, venous disorders such as varicose veins, spider veins, or deep vein thrombosis, as well as inflammatory conditions such as vasculitis, angiopathy, and diabetic retinopathy.

How can I recognize vascular diseases, and why is early diagnosis so important?
Signs may include swollen legs, pain when walking (intermittent claudication), skin changes, or symptoms of congestion caused by the backflow of blood. Early detection of vascular diseases is important because untreated narrowing of blood vessels, stenosis, or complete occlusion can have serious consequences for tissues and organs.

How do vascular diseases develop, and what role do deposits in the vessel walls play?
Many vascular diseases develop due to deposits on the vessel walls, such as atherosclerosis resulting from arteriosclerosis. Such pathological changes narrow the vessel diameter, impair blood flow, and can trigger a wide variety of occlusive diseases.

What symptoms occur in arterial and venous vascular diseases?
Arterial diseases often lead to pain during physical exertion, typically resulting in peripheral arterial occlusive disease. Venous diseases tend to cause swollen, heavy legs, visible changes in the veins, and symptoms that worsen with prolonged sitting or standing. Deep vein thrombosis can become dangerous if a blood clot breaks loose.

What causes vascular narrowing, stenosis, or pathological dilation?
Vascular narrowing (stenosis) is often caused by deposits, inflammatory processes, or weakness of the connective tissue. Pathological dilation of blood vessels is also possible, such as in the case of an aneurysm. Both conditions impair the vascular system and must be medically diagnosed and treated.

What role do diabetes, inflammatory diseases, or lymphatic disorders play?
Diabetic angiopathies can damage small blood vessels and reduce blood flow. Inflammatory vascular diseases such as vasculitis directly affect the vessel walls and can impair blood flow in arterial and venous vessels. Lymphatic disorders lead to fluid retention because tissues are no longer adequately supplied with oxygen and lymph is not properly drained.

How are vascular diseases diagnosed and treated?
Depending on the clinical presentation, diagnosis is made through medical history, physical examination, duplex ultrasound, imaging techniques, and functional tests. Treatment ranges from medications and compression therapy to minimally invasive procedures and surgical interventions aimed at eliminating vascular narrowing and improving blood flow.