Vascular medicine

Atherosclerosis is a disease affecting the arteries and characterized by the formation of atheromatous plaques . It is a frequent cause of stroke and tissue ischemia. When it affects the abdominal aorta and the arteries supplying the legs, it is called peripheral artery disease (PAD). PAD presents in different stages depending on its severity, with pain that initially occurs when walking (claudication) , then at rest (pain when lying down) , and can even lead to arterial ulcers .

Elastic tissue diseases encompass a range of pathologies that can cause dissection or other skeletal, cutaneous, or ocular manifestations.

Chronic venous insufficiency is a disorder of venous circulation that affects the legs.

The first stage of the disease is characterized by the presence of varicose veins , followed by swelling or edema of the ankle. Next, the skin takes on a brownish color. In the most advanced stage of the disease, a sore may form, which is difficult to heal; this is called a varicose ulcer.

Venous thromboembolic disease is caused by the formation of a clot, or thrombus, in the bloodstream. Its two main forms are deep vein thrombosis or phlebitis and pulmonary embolism .

More than 70% of pulmonary embolisms occur as a result of deep vein thrombosis, with blood clots obstructing the veins of the lower limbs migrating to the pulmonary circulation.

An aneurysm is a dilation of the wall of an artery, resulting in the formation of a sac of varying size in small, medium, or large arteries. This sac gradually enlarges and can rupture when the pressure becomes too great; this is an aneurysm rupture, which is a serious complication regardless of its location.

Acrosyndromes are abnormalities of circulation in the hands or feet.

The most well-known acrosyndrome is Raynaud's phenomenon. This is a circulatory disorder of the extremities, characterized by a change in skin color which becomes white, then possibly a bluish color, associated with tingling and a sensation of numb fingers.

In 80% of cases, this acrosyndrome is not linked to an underlying pathology.

During the consultation, the doctor looks for associated signs such as joint pain, difficulty swallowing, shortness of breath, thickening of the skin on the hands or finger wounds that are slow to heal.

Further investigations may be prescribed: periungual capillaroscopy, blood tests to rule out secondary causes. An arterial Doppler ultrasound and digital pressure measurement may also be useful.