Angiology

In Spain, over 72% of women between the ages of 30 and 60 are concerned about circulatory problems in their legs. Their concerns are typically focused around the adverse effects of poor circulation on their overall health, the pain they may suffer as a result, and how their physical appearance may be affected.

At Hospital Ochoa we offer our patients the most advanced medical and surgical expertise for analysing and solving vascular pathologies.

Angiology is the medical speciality dedicated to the study, prevention and treatment of health issues affecting the circulatory and lymphatic systems, i.e. arteries, veins and lymphatic vessels. Together with the heart, these vessels are responsible for the distribution of nutrients throughout the body.

One of the most common problems affecting blood vessels is peripheral artery disease (PAD), which is the abnormal narrowing of arteries, typically in the legs, and forces patients to pause frequently when walking (intermittent claudication).

Phlebology

Within angiology, the most common pathologies pertain to the veins (venous), and the medical branch exclusively dedicated to them is called phlebology.

The most common disorder within phlebology is venous insufficiency, which is when veins have trouble sending blood back from the limbs to the heart.

Depending on the severity, varicose veins are divided into four types:

  • Grade I. Also called spider veins, they are characterised by being very fine and purplish in colour. They are usually a purely aesthetic problem, although they may sometimes cause the legs to feel heavy.
  • Grade II. These are more visible and cause tiredness in the legs, tingling sensations, cramps, pain, and even the feeling of heat or itchiness.
  • Grade III. The veins become more dilated and the symptoms more severe. The legs tend to swell and there may be a change in skin pigmentation.
  • Grade IV. These are the most serious. Areas with ulcers and eczemas are very frequent.

Symptoms

Patients with venous insufficiency often report a feeling of heaviness, tightness or tiredness in their legs. Factors such as summer heat and standing for long hours, can transform these manifestations into localised pain.

Itching, vein dilation and skin discoloration are other symptoms of this disorder, which is fundamentally hereditary.

Surgical treatment

  • Stripping. This technique is increasingly falling out of use due to its aggressive and painful nature. It consists of removing all or part of the saphenous vein, which is the largest vein in the body and extends from the ankle to the groin. It requires two or three days of hospitalisation and up to ten days of complete rest after the operation.
  • Endovenous laser and radiofrequency ablation. A narrow tube called a catheter is inserted into the vein using an ultrasound scan. Then either a laser or radiofrequency probe is passed through the catheter, which heats up the vein until it is sealed closed. Blood flow will naturally be redirected through a healthy vein, and the damaged varicose vein will fade away.
  • Sclerotherapy. A substance is injected into the vein, irritating and sealing it, and eventually the vein will fade away. The procedure may take a number of repeated sessions, but no anesthesia is necessary. The patient is required to wear compression stockings for at least a few weeks after the operation.
  • CHIVA treatment. The ambulatory conservative hemodynamic correction of venous insufficiency (CHIVA) method aims to improve the hemodynamic disorder without destroying the veins. A Doppler ultrasound is used to map out the column of blood vessels, and these are divided into sections so that pressure is divided equally amongst them. Insufficient valves are tied off and blood is no longer able to flow backwards. It is performed under local anesthesia and on an outpatient basis.

Diagnostic tests

The advent of ultrasound was a medical revolution. Today’s Doppler ultrasound is an imaging test that uses sound waves to show blood moving through blood vessels. It has greatly enabled medical personnel, particularly angiologists, to perform more precise diagnoses and treatments.

  • Color Doppler. Ultrasounds have been around starting in the 1980s, but their definition has greatly improved since then as evidenced by the current generation of Color Doppler. The ultrasound visualises the alterations inside the veins and arteries, and a Doppler technique used by traffic radars is applied to determine the blood flow and potential issues. The patient must stand in order to obtain optimum results, and it is a painless and harmless test.
  • Lymphography. Another imaging technique in which a radiocontrast agent is injected into the body, and then an X-ray picture is taken to visualise the lymphatic system. Lymph nodes, lymph ducts, lymphatic tissues, lymph capillaries and lymph vessels can be easily observed with this method.

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