Vascular Disease in Women Aimee Swartz, MD RPVI Vascular and Endovascular Associates of WNY
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
Risk Factors for Vascular Disease Cigarettes ALL nicotine containing products Age >50 Diabetes High blood pressure High cholesterol Family history African American
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;125:1449-1472
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
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
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
Cerebrovascular Disease Diagnostic Test Duplex ultrasound CTA MRA
Cerebrovascular Disease Diagnostic Test Duplex ultrasound CTA MRA Source of image is Red River Valley Radiology Associates Website, http://www.rrvr.net/images/image_gallery/cta- Carotid3.jpg
Cerebrovascular Disease Diagnostic Test Duplex ultrasound CTA MRA Source of image: www.science.gmu.edu/~jcebral/rese/biofluids/car08
Cerebrovascular Disease Treatment Medical Management Controlling risk factors Aspirin/Plavix Surgery Carotid Endarterectomy Carotid Artery Stent
Cerebrovascular Disease Treatment Medical Management Controlling risk factors Aspirin/Plavix Surgery Carotid Endarterectomy Carotid Artery Stent
Cerebrovascular Disease Treatment Medical Management Controlling risk factors Aspirin/Plavix Surgery Carotid Endarterectomy Carotid Artery Stent
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
Peripheral Vascular Disease Narrowing or blockage of blood vessels in the extremities Most commonly affecting the legs
Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene
Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene
Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene
Peripheral Vascular Disease Symptoms Asymptomatic 15% women vs. 9% men Claudication Pain at rest Ulcers Gangrene
Peripheral Vascular Disease Diagnostic Testing Vascular Lab studies ABIs Doppler CT scan Angiogram
Peripheral Vascular Disease Diagnostic Testing Vascular Lab studies ABIs Doppler CT scan Angiogram
Peripheral Vascular Disease Diagnostic Testing Vascular Lab studies ABIs Doppler CT scan Angiogram
Peripheral Vascular Disease Treatment Smoking cessation Medications Controlling risk factors Aspirin/Plavix Exercise regimen Development of collaterals 30 minutes 5x/week
Peripheral Vascular Disease Surgical Treatment Angioplasty Stent Bypass
Peripheral Vascular Disease Surgical Treatment Angioplasty Stent Bypass
Peripheral Vascular Disease Prognosis Best with early diagnosis and treatment 6-7x risk of heart attack and stroke
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
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