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A to Z of vascular medicine

 

What can I find in this section?

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Unfortunately, specialist terminology cannot always be avoided, especially when it comes to such a complex subject as medicine. For this reason, our A to Z of vascular medicine provides you with a short description of an array of terms, sorted in alphabetical order.

 

 A  B  C  D  E  F  G  H  I  L  M  N  O  P  R  S  U  V 


Angiology

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Angiology constitutes a part of internal medicine, that deals with vascular diseases (arteries, veins, lymphatic vessels). Angiologists are therefore occupied with the formation, epidemiology, diagnosis and of course the various forms of therapy (including rehabilitation and prevention) of vascular medicine.

 

Aneurysm

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An Aneurysm is a dilation of the vessel wall, generally of the abdomen. For example, if the abdominal aorta dilates in excess of 3mm, it’s considered an aneurysm. In rare cases aneurysms can be innate, but usually they are caused by arteriosclerosis in middle age. Aneurysms generally don’t cause any symptoms; therefore, preventive check-ups are recommended from the age of 50.

 

Apoplexy

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Is also known as a stroke, is caused by a circulatory disorder of the brain arteries, leading to signs of paralysis in the arms legs or in the face or reduced vision.

 

Arteries

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The arteries are the vessels that lead the blood away from the heart, in other words it transports the oxygen-rich blood from the heart to the organs and extremities.

 

Atherectomy

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With a special catheter, deposits in the arteries, called plaques, can be removed through atherectomy.

 

Atherosclerosis

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Over time deposits in the vessels may calcify and create so-called plaques, that can constrict the vessels, leading to a restriction of the blood flow. These plaques can break away and depending on the location, my lead to a life-threatening situation (blocked vessel in the leg, heart attack, stroke). There are risk factors that promote these calcifications, such as smoking, increased blood fat values, high blood pressure, diabetes mellitus.

 

Balloon dilation

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With the help of an inflatable balloon, constricted vessel can be dilated, thus reallowing blood flow. If the balloon dilatation does not suffice, these constrictions are treated with small stents.

 

Calf muscle pump

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The muscles of the calf act as a natural pump of the the legs, transporting both venous blood and lymph against gravity from the leg back to the heart.

 

Cholesterol embolism

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With cholesterol embolisms, small pieces are washed from the plaques and then deposited via the blood stream in the smallest vessels, usually in the toes, which results in an acute circulatory disorder of these parts of the body. Cholesterol embolisms are caused by frequent pronounced plaque formation in the abdominal artery (particularly in the case of an abdominal aorta aneurysm) and in the pelvic arteries.

 

Chronic venous insufficiency

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Chronic venous insufficiency is frequently characterised by swelling in the legs and changes to the skin. Chronic venous insufficiency can be caused by weaknesses in the vein valves in the superficial vein system (see varicosis) or in the deep vein system. In the event of progressive venous weakness, in addition to changes to the skin, non-healing ulcers (“ulcus cruris”) can appear on the legs.

 

Computer tomography angiography (CTA)

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The computer tomography angiography is a non-invasive examination in order to, with the aid of contrast agent and an associated “tube examination”, visualise the vessels. The computer tomography is used mainly to visualise the vessels in the abdomen, and has a high degree of accuracy in the evaluation of changes to the vascular wall in regions which it is hard to examine sonographically.

 

Corona phlebectatica

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Corona phlebectatica is the presence of spider veins which occur on the ankle and which can frequently indicate a vascular weakness.

 

Crosse

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Crosse is the end of a large superficial skin vein in the deep guide veins. Termination point of the large superficial skin veins (groin or the hollow of the knee) in the deep guide veins.

 

Crosse insufficiency

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Blood from the deep vein system returns pathologically via the crosse into the superficial main veins.

 

Compression stockings

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As the name suggests, these stocking exert pressure on the connective tissue, which helps and thus improves the performance of the muscle pump, which transports the venous blood back from the legs to the heart. They are available in various materials and lengths.

 

Compression therapy

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As congestion can be more or less severe, treatments differ as well. Sometimes bandaging can be easier than compression stockings, as they are easier to dose. For lymphoedema foam pads or pelottes can be used for bandaging.

 

Digital subtraction angiography (DSA)

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To evaluate vascular changes and abnormalities, the digital subtraction angiography (DSA), being part of catheter interventions, is considered as one of the most precise methods.

With the aid of the DSA, the results are presented following catheter interventions.

 

Diabetes mellitus

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Diabetes commonly known as the “sugar disease” is a metabolic disorder where blood sugar levels are elevated. These pathological high blood sugar levels provoke metabolic changes that result for example in arteriosclerosis, which frequently affect the arteires of the lower leg.

 

Duplex sonography

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This is a combination of the standard ultrasound image and a colour-coded blood flow measurement (Doppler examination). The Doppler examination is used to determine the volume and the speed of the blood flow. The duplex sonography is the most frequently used examination to evaluate vessels.

 

Embolism

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An embolism is a lodging blood clot that developed and originated in the vein system (commonly in the legs) or in the artery system (usually in the heart). On the one hand a pulmonary embolism for example a blood clot travelling in the vein system, blocking a pulmonary vessel (characterized by shortness of breath and coughing up blood). A stroke on the other hand arises in the arterial system blocking an artery supplying the brain (sudden paraesthesia, paralysis, impaired vision) or for example occluding an artery in the leg (sudden pain in the leg or in the calf when walking).

 

Erysipelas

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This is a usually a bacterial inflammation of the superficial lymphatic vessel under the skin.

 

Exercise therapy

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Exercise therapy is a supporting but very important method to sustain the the success of manual lymph drainage and instrument base compression. The exercise program is usually established by the lymph therapy which should be carried out daily.

 

Flat-knit stocking

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This is a compression stocking, which isn’t elastic, comparable to a bandage, that is used as treatment of lymph oedemas and advanced chronic venous insufficiency.

 

Foam sclerotherapy

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For the sclerotherapy treatment, usually Atehoxysklerol is is mixed with air which foams up and thus increasing the surface of the substance. The injection of the foam provokes an artificial inflammation of the vein, which results in the adhesion and later the breakdown of the vein wall. The increased pigment deposit in the region of the sealed vein disappears as the vein is resorbed by the body.

 

Gait training

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Gait training can promote the formation of side veins / collaterals in the case of blockages in the legs. This results in longer pain-free stretches on foot. Along with the determination of the vascular risk factors, gait training forms the basis for the treatment of the peripheral arterial disease.

 

Guide veins

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Guide veins are the veins that constitute the the deep vein system. If these are dysfunctional, veins with nutritional disturbances in the superficial layers of the skin can swell, which could end in a ulcus cruris.

 

Heparin

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Short-term medication used for the prevention of blood-clots. There are two ways for it to be administered: If it’s on a out-patient basis it can be injected 1-2 times a day under the skin. During a hospital stay it’s administered through steady infusions. Heparins are used for bed-ridden patients or are part of the after-surgery therapy to prevent vein thromboses.

 

High blood pressure

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Blood pressure is defined as high if the the upper value (systole) exceeds 140mmHG or the lower value (diastole) exceed 90mmHG. Usually, high blood pressure doesn’t cause any symptoms, but it can cause damage to vital organs such as, the heart, the kidney and the even the eyes.

 

Hyperlipidemia

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In hyperlipidaemia, meaning elevated blood fats, we distinguish the neutral fats (triglycerides) and the colloquially known “bad” cholesterol (LDL cholesterol). Healthy people with no vascular risk can have a value up to 160mg/dl LDL cholesterol and up to 200mg/dl triglycerides (in fasting serum) to be considered normal. If there is a vascular risk, such as arteriosclerosis with constrictions, these values especially LDL cholesterol should be reduced to less than 100mg/dl (sometimes even less than 70 mg/dl). Additionally to the elevated LDL cholesterol, further, rarer lipid protein particles (such as lipoprotein(a)) can result in arteriosclerosis.

 

Imaging methods

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In vascular medicine the most frequently used imaging methode is the duplex sonography. But in some special cases, an MR angiography, CT angiography and a digital substraction angiography (DSA) is also used.

 

Instrument-based drainage

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Here cuffs are attached to the extremities, which through pressure waves, transport the fluid in the tissue towards the abdomen and chest. Manual lymph drainage often complements the the instrument-based compression. Additionally, well fitted compression stockings are important to guarantee the success of the drainage treatment.

 

Laser

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A laser is a source of light that emits one wavelength that run parallelly. Thus concentrating energy onto one spot. Lasers are used in many different fields in medicine. In angiology, it’s used as a minimal invasive treatment for spider veins or for the main superficial veins.

 

Light reflection rheography

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In light reflection rheography infrared light is used as a screening method to asses the venous flow in the superficial layer of the skin in a non invasive and painless way. By evaluating the the venous flow in the superficial vein system, it’s possible to deduce the quality of the calf muscle pump and the function of the vein valves.

 

Lipedema

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The lipoedema is a genetically caused immoderate growth of subcutaneous fatty tissue, which often appears in women. This increase of fatty tissue leads to an accumulation of tissue fluid with associated symptoms of congestion (swelling of the legs, pressure pain, feeling of heaviness in the lower extremities).

 

Lymph

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Lymph is tissue fluid that flows between cells in all bodily tissues and is transported away by lymphatic vessels. It contains metabolites (e.g. remnants of dead cells and proteins). In the lymphatic vessels, muscle cells may be found, which transport the lymph in the direction of the abdomen and the chest (“lymph pump”). These muscle cells can’t drain the tissue fluid on their own, therefore they rely on the pumping system of the musculature.

 

Lymphedema

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The lymphoedema is a doughy swelling of the skin, which initially is painless and can be reduced by raising the arms and legs. It can be detected if, by pressing down the skin it leaves a dent. Typically, a primary lymphoedema is innate and starts in early adulthood, but it can also commence earlier, in childhood with increased swelling of the hands or feet. Secondary lymphoedema are caused by a different underlying illness, which generally occur later in adulthood and can be a sign for a disturbance of the venous drainage system in the region of the chest and abdomen.

 

Magnetic resonance angiography

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With the help of the magnetic resonance angiograph (MRA), the blood flow in the vessels and the condition of the vascular walls is illustrated with the aid of a magnetic field analysis (without x-ray). The MRA is often used for catheter interventions. It’s a rule that MRA’s are not to be performed on patients with heart pacemakers.

 

Main veins

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The large superficial veins which flow together with the deep vein in the region of the groin and the knee joint are considered as the main veins. In Latin, they are called vena saphena magna and vena saphena parva or more commonly as the great and small saphenous vein.

 

Manual lymph drainage

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As the name suggests it’s lymph drainage technique, whereby the congested lymphatic fluid is transported, with help of a special massage, in the direction of the abdomen and chest. This therapy is often complemented by a compression therapy, in order to guarantee and sustain the success of the treatment.

 

Mini-phlebectomy

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The mini-phlebectomy is a therapy where the dilated lateral saphenous branch veins (diameter of >3mm) are pulled out through a small hole in the skin (1mm) with a small thin hook, all under local anesthesia and thus removing them permanently.

 

Nicotine abuse

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Out of all patients with circulatory disorders in the legs, half of them are smokers. Nicotine consumption leads to free radicals and oxidized LDL cholesterol particles which are causing the formation of arteriosclerosis(calcification of the vessels).

 

NOAC

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Short for New Oral Anticoagulants: these are medications for blood thinning and are usually used for the treatment of deep vein thromboses. NOACs can also be used in “half doses” for long term treatment as a prevention in patients with leg vein thrombosis without any discernible cause.

 

Oedema

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Oedema is a swelling of a tissue caused by congested fluids.

 

Overweight

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People with a Body Mass Index (BMI) of between 26 an 30 are classified as overweight. The BMI ist calculated as such: weight(kg)/(height(m)xheight(m)).

For example, a person weighing 60 kg and measuring 168cm in height, the Body Mass Index would be: 60kg/1,68mx1,68m=21.

BMI values above 30 are classified as obesity. Being overweight and having an abdominal fat mass that is too high (waist measurement above 80cm for women, above 94cm for men) increase the risk of developing diabetes, high blood pressure or a cardiovascular disease.

 

Perforating veins

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The perforating veins connect the deep and the superficial vein system. If on the one hand the blood flows from the superficial veins into the deep veins, the normal transport function is sustained. On the other hand, if it flows from the deep veins into the superficial vein system, this might be a sign for valve weakness, which are frequently accompanied with the formation of varicose veins. Perforating veins are frequently successfully treated by the means of sclerotherapy.

 

Peripheral arterial disease (PAD, window shopper’s disease)

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Arterial disease is defined by the presence of constrictions in the arteries. PAD is sometimes referred to as “window shopper’s disease”, since patients frequently are forced to stop because of exercise-related pains in the legs. Patients suffering from peripheral arterial disease are up to three times more likely to suffer a heart attack or a stroke. The increased risk does not only apply to symptomatic patients, but also to patients that have asymptomatic constrictions. It is said that PAD may reduce the life expectancy by around 10 years, with heart attack and stroke being the most frequent causes of death.

 

Phlebitis

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Phlebitis is an inflammation of a superficial vein, usually a varicose vein that presents itself as hardened and reddened and is usually caused by superficial located clot (not to be confused with the formation of a blood clot- thrombosis- in the deep vein system).

 

Phlebology

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The study of venous diseases. Phlebology occupies itself in particular with the treatment of varicose veins and diseases of the deep vein system.

 

Phlebothrombosis

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Phlebothrombosis is the formation of a blood lump in the deep vein system, which often appear in the lower leg and if not treated is lead to the growth of the blood clot. The risk os a pulmonary embolism increases with the the growth of the clot in larger guide veins.

 

Post-thrombotic syndrome

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Post thrombotic syndrome results from the a earlier case of phlebothrombosis, which can lead to a permanent weakness in the deep vein system. The swelling of the leg and the changes to the skin constitute the post-thrombotic syndrome. In severe cases, it can result in a venous ulcer.

 

Pulmonary embolism

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Acute blockage of a pulmonary vessel by a blood lump, which usually developed in the pelvic veins or in the deep leg veins.

 

Radio wave therapy

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Radio wave therapy is a minimal invasive way to close a insufficiently functioning vein (vena saphena magna or vena saphena parva) by applying high heat and thus breaking it down over the long term. The result is a normalized blood flow in the leg, and a regression of the symptoms caused by congestion.

 

Raynaud’s phenomenon

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Raynaud’s phenomenon get it’s name from the French doctor Maurice Raynaud who described this disorder in the 19th century. The fingers turn pale, thus why is also known as “white finger”. Around 10% of the population – often women – suffer from this disorder when exposed to the cold. It’s usually harmless, although in rare cases there is an association with rheumatic disease.

 

Reticular varices

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Reticular varices are small varicose veins with a diameter of 1-3mm. Like spider veins, they hardly cause symptoms.

 

Recurrent varicosis

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The reappearance of a varicosis in the area of a treated varices in past, is referred to as recurrent.

 

Round-knit stocking

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A round-knit stocking is the most frequently used compression stocking. It’s elastic and used to prevent swollen legs, especially for pure venous diseases.

 

Saphenous varicosis

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Saphenous varicosis is the insufficiency of the great saphenous veins in the superficial vein system of the skin (vena saphena magna or vena saphena parva) often going hand in hand with varicosis of the lateral saphenous branches (varicose vein located directly under the skin) which have a diameter in excess of 3mm.

 

Sclerotization

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Sclerotization or sclerotization therapy is the closing of veins through administration of vein-closing substances (usually Aethoxysklerol) by the means of injection in order to treat smaller varicosis. A slight stinging sensation may occur during injection at the injection site, but usually only for a short period of time. As the amount of pain is low, local anesthesia isn’t normally required.

 

Smoking

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Around 50% of all patients who suffer from peripheral arterial disease are smokers. Cigarettes contain more than 5000 toxins, that promote the formation of “free radicals” and therefore promote arteriosclerosis.

 

Starburst varices

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Starburst varices are thinnest (generally less than 1mm thick), smallest superficial veins located in the skin.

 

Stemmer sign

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When the skin above the fingers or toes can no longer be pinched or lifted, this is a typical sign for lymphoedema.

 

Stent

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A stent is a frame for the vessel and acts as a vascular support. The diameter ranges from 3 to 12mm and can expand by themselves or with the help with the inflation of a balloon, which can stabilise a venous occlusion. The self expanding stents can, due to a memory effect of the metal or of the mesh, return to their original state and are used, as a rule, for constrictions of the arteries of the thigh. The balloon-mounted stent, can only expand with the help of an inflatable balloon and as a rule are used for the constricted vessels of the pelvis and abdomen (e.g. the renal arteries).

 

Stripping

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Stripping is a formerly frequently used technic to treat main vein insufficiency (vena saphena magna or vena saphena parva) , by pulling it out in the region of the groin crosse. This method is increasingly being replaced by gentler methods (endovascular methods). With the newer methods, no general anesthesia is necessary anymore, crosse no longer has to be stripped and the operation can easily be performed on a out-patient basis under local anaesthetic.

 

Stroke

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A stroke is an acute circulatory disorder of the arteries supplying the brain, which may present itself with temporary or permanent impaired vision, weakness in the arms and legs as well as paralysis in the face or even paranesthesia. It may come to a dying-off of brain cells caused by the lack of oxygen, if the brain artery is blocked for more than six hours.

 

Ulcus cruris

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The ulcus cruris is a lesion of the skin, that develops because of a combination of venous weakness and tiny injuries, that lead to a permanent sore. This kind of wound can be dangerous as it may increase in size and become very painful and over time could get infected (erysipelas), which if not treated correctly, can result in fever, shivering, sepsis and further complications.

 

Varicosis of lateral saphenous branches

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The varicosis of lateral branches is a varicose that develops frequently because of the leakage of the perforating veins and of the main veins. They are located at the surface of the skin and have diameter less than 3mm.

 


In an emergency

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Outside of surgery hours,
please call the emergency
medical assistance service on:
Telephone number 116 117.

Münchner Freiheit
Vascular Centre

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Haimhauserstraße 4 | 80802 Munich
T: 089 33 76 66+49 (0)89 33 76 66
F: +49 (0)89 33 76 25
E: info(at)gefaesszentrum-muenchner-freiheit.de

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