Atherosclerosis -- a "Hard" Problem to Treat

Atherosclerosis – that’s a fancy $100 word that is medical jargon for a common problem known as “hardening of the arteries.” Much of what our practice does is deal with the consequences of this disease, as the clogging, blocking, and breakdown effect it has on the body’s blood vessels can be disastrous.

Many common problems in your body are caused or worsened by buildup of what is commonly called “plaque” inside the blood vessels. One of the most significant examples is heart disease, also called coronary artery disease. This problem is treated by cardiologists and cardiac surgeons. Apart from that, most other problems caused by hardening of the arteries are treated by vascular surgeon, and several examples exist all through the body.

• Stroke, caused by the buildup of plaque inside your neck arteries and then travel of that plaque into your brain, can be a deadly and life-threatening problem, as a large stroke can cause life-long paralysis, weakness, lack of ability to speak or walk, or even death.
  
• Peripheral artery disease as it’s commonly termed, is the buildup of plaque inside the arteries to the legs. This can cause problems with walking, including pain and cramping. It can also inhibit the body’s ability to heal problems in the feet or toes, and cause major problems like gangrene, and its worst stages, even necessitate amputation of a limb. 
  
  
• Buildup of plaque blocking the arteries to your small intestine and colon, although less common, can cause severe, life-threatening problems with eating, including severe pain, weight loss, nutritional problems, or even parts of your bowel dying. This can also result in death, if enough of your bowel has poor blood flow for long enough.
  
  
• Blockage of the blood vessels feeding the kidneys is less common, but can result in very difficult-to-control blood pressure, meaning the patient requires many blood pressure medications to keep their blood pressure in a normal range. If this progresses, the patient can progress to kidney failure and ultimately require dialysis.
  
  
• Weakness and bulging of the blood vessel wall, called an aneurysm, can be caused by atherosclerosis as well. Aneurysms can clot, burst, or bleed, causing life and limb threatening problems.

What causes atherosclerosis? Many common medical conditions can cause or contribute to a patient’s overall chances of having atherosclerosis. These things are called “risk factors” and can include things like high blood pressure, high cholesterol, obesity, diabetes, smoking tobacco products, male gender, and more advanced age. In addition, if you have first-degree family members with any of those conditions, your risk for developing hardening of the arteries also increases.

How is atherosclerosis treated? It can be treated initially with “management” of the risk factors listed above. In general, that means controlling one’s blood pressure and cholesterol, whether with diet, exercise, or medication, or some combination of those. Minimizing or quitting smoking can also prevent complications of hardening of the arteries. In addition, low dose of a mild blood thinner called aspirin is also recommended in patients with known hardening of the arteries, as it can help prevent small clots in the vessels caused by the plaque.

Vascular surgeons are involved with all aspects of treatment of this problem, however most of our work involves improving, fixing , or preventing the problems caused by progressive disease. We use many special devices to open up blockages, or when blockages become too severe to open with minimally invasive techniques, surgery to remove or bypass the plaque may become necessary. The important thing to realize is that with minor procedures or even major surgery, we can never cure atherosclerosis—it’s an “all-over-the-body” disease process that requires close monitoring, regular testing, and an “all-in” approach to help fight.

Please let us at Vascular Surgery Associates know if you believe you or someone you know may have this condition, or problems potentially caused by it. We will be happy to see you in consultation and evaluate further.

Author

Micah Girotti, MD Micah Girotti, MD, FSVS, is a board-certified vascular surgeon who joined the team at Vascular Surgery Associates, LLC, in July 2017. He is dedicated to providing personalized, high-quality care to patients in Bel Air, Towson, and Elkton, Maryland.