Leg pain when walking is common. The most common vascular reason is peripheral artery disease (PAD). This leg pain is called intermittent claudication. But, many causes of leg pain when walking are not vascular. Figuring out the cause is not always simple. 6 Causes for Leg Pain when Walking that are NOT vascular Leg pain…
Buerger’s disease is also called thromboangiitis obliterans. It is associated with smoking and affects the arteries, veins and nerves. The only real treatment is smoking cessation. Avoiding chewing tobacco and marijuana is also critical. What causes Buerger’s disease? Buerger’s disease is typically a disease of young men. If a patient is older than 45 years,…
Intermittent claudication means there is leg pain when walking. We can measure the blood flow to the legs with simple blood pressure cuffs. The ratio of blood reaching the legs to the blood reaching the arms is called the ankle brachial index or ABI. The lower the ABI, the worse the blood flow is. As…
Homocysteine is an intermediate amino-acid. Elevated levels of homocysteine, are called hyperhomocysteinemia. 5-7% of the population have hyperhomocysteinemia. Hyperhomocysteinemia correlates with accelerated atherosclerosis and with recurrent venous thrombosis. Severe hyperhomocysteinemia may be part of a syndrome called homocysteinuria. Causes for elevated homocysteine Homocysteine levels are elevated because of genetic factors or because of lack of…
Carotid artery occlusion may be found incidentally or when looking for a cause for acute stroke. It can be an endpoint of carotid artery stenosis or a result of a large embolus. In both cases occlusion results from thrombosis. Diagnosis The diagnosis of carotid artery occlusion is made by vascular imaging. Duplex ultrasound can show…
Carotid artery stenosis treatment can be medical, endovascular or surgical. It is a matter of debate. On the one hand, not interfering with the natural history of a disease may sometimes result in a stroke. This is especially true in symptomatic patients. On the other hand treatment itself may result in unwanted consequences. Patients may…
Patients with peripheral artery disease are sick. They often do not only have disease in their legs, but also in other vascular beds such as the brain and the heart. Therefore, some would suggest prescribing antiplatelet agents such as aspirin or clopidogrel to these patients for primary prevention of cardiovascular events. Some actually claim that…
Treating a patient that has carotid artery stenosis can potentially cause damage. So intervention needs to balance risk of stroke with medical therapy. It is well known that the benefit of treating carotid artery stenosis is higher in symptomatic patients than in asymptomatic patients. If the patient is asymptomatic and has never had a stroke…
Upper extremity embolism will result in upper extremity ischemia. The onset is usually acute. The extremity or part of it will be painful. There will be change of color. The color will be either bluish or pale, white. The limb will be cold. In more advanced cases, there will be limited sensation and motor function….
The treatment of vascular disease is shifting greatly toward endovascular procedures. The essential tools of endovascular procedures are angioplasty and stent. Unfortunately artery restenosis plagues both these procedures. Most information about artery restenosis comes from the coronary literature. Reported artery restenosis rates even with the best antiplatelet therapy are 3-5%. Without this treatment restenosis rates…
