Vascular Disease in Women. Aimee Swartz, MD RPVI Vascular and Endovascular Associates of WNY

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1 Vascular Disease in Women Aimee Swartz, MD RPVI Vascular and Endovascular Associates of WNY

2 Vascular Disease Atherosclerosis Hardening of the arteries Restriction of blood flow Arteries beyond the heart become narrowed or clogged Cerebrovascular disease Arteries of the neck and brain Peripheral vascular disease Arteries of the arms and legs

3 Risk Factors for Vascular Disease Cigarettes ALL nicotine containing products Age >50 Diabetes High blood pressure High cholesterol Family history African American

4 Vascular Disease in Women Gender-specific prevalence of peripheral artery disease (PAD) by age group. Incidence is as high in women as it is men Affects >10 million Americans Alan T. Hirsch et al. Circulation. 2012;125:

5 Cerebrovascular Disease Atherosclerosis involving the neck arteries Some of the plaque or clot that adhere to the artery can break off and travel to the brain causing a STROKE

6 Cerebrovascular Disease Symptoms Unable to control or move one side of the body Losing vision in one eye curtains coming down Unable to speak clearly Transient or lasting symptoms

7 Cerebrovascular Disease Symptoms Unable to control or move one side of the body Losing vision in one eye curtains coming down Unable to speak clearly Transient or lasting symptoms

8 Cerebrovascular Disease Diagnostic Test Duplex ultrasound CTA MRA

9 Cerebrovascular Disease Diagnostic Test Duplex ultrasound CTA MRA Source of image is Red River Valley Radiology Associates Website, Carotid3.jpg

10 Cerebrovascular Disease Diagnostic Test Duplex ultrasound CTA MRA Source of image:

11 Cerebrovascular Disease Treatment Medical Management Controlling risk factors Aspirin/Plavix Surgery Carotid Endarterectomy Carotid Artery Stent

12 Cerebrovascular Disease Treatment Medical Management Controlling risk factors Aspirin/Plavix Surgery Carotid Endarterectomy Carotid Artery Stent

13 Cerebrovascular Disease Treatment Medical Management Controlling risk factors Aspirin/Plavix Surgery Carotid Endarterectomy Carotid Artery Stent

14 Cerebrovascular Disease Prognosis Poor once patient is symptomatic 5 year survival <60% Improved prognosis with Early diagnosis Management of systemic disease Limiting progression of disease

15 Peripheral Vascular Disease Narrowing or blockage of blood vessels in the extremities Most commonly affecting the legs

16 Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene

17 Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene

18 Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene

19 Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene

20 Peripheral Vascular Disease Diagnostic Testing Vascular Lab studies ABIs Doppler CT scan Angiogram

21 Peripheral Vascular Disease Diagnostic Testing Vascular Lab studies ABIs Doppler CT scan Angiogram

22 Peripheral Vascular Disease Diagnostic Testing Vascular Lab studies ABIs Doppler CT scan Angiogram

23 Peripheral Vascular Disease Treatment Smoking cessation Medications Controlling risk factors Aspirin/Plavix Exercise regimen Development of collaterals 30 minutes 5x/week

24 Peripheral Vascular Disease Surgical Treatment Angioplasty Stent Bypass

25 Peripheral Vascular Disease Surgical Treatment Angioplasty Stent Bypass

26 Peripheral Vascular Disease Prognosis Best with early diagnosis and treatment 6-7x risk of heart attack and stroke

27 Vascular Screening Held 3-4x per year in Buffalo hosted by the Catholic Health System Earliest is February 28 th Scanned from head to toe Carotid ultrasound Abdominal ultrasound Evaluate for aneurysm Arterial Brachial Indices Identify patients at risk that would benefit from early intervention and management

28 Conclusions Vascular disease is very common in both men and women Consequences from severe disease can be life changing (loss or independence) or life ending Early diagnosis and treatment is the key to limiting the progression of disease and thus limiting complications