All other vascular conditions
can be investigated and treated also. These
include:
Narrowing or blockages in the arteries
in the pelvis or legs may cause symptoms due to an inadequate blood supply to
the legs. Cramp-like pain in the
calf or thigh on exercise may limit the patient’s ability top walk. Investigation is initially with duplex ultrasound but may
require an angiogram, where X-ray contrast is injected into the artery in the
groin to show any blockages or narrowing. Treatment
options vary according to the severity of the condition but may include
angioplasty, stenting or even peripheral bypass surgery.
Severe peripheral disease may cause toe
gangrene, leg ulcers or pain in the foot at rest.
This requires urgent investigation with angiography and often requires
bypass surgery.
This is a swelling of the main artery in
the body inside the abdomen. It
mainly affects men over 60 years. It
is easily detected by ultrasound and CT. The
main risk from this condition is death by rupture of the aneurysm. When the aneurysm reaches a certain size (5.5cm) an operation
is recommended to repair the aneurysm. Prior
to surgery tests are carried out to ensure that the patient’s cardiac function
is good enough to withstand the stress of surgery. This is done by stress Echocardiography or MUGA scanning.
Complicated aneurysms involving the suprarenal and thoracic aorta can be
treated also.
Disease in the carotid artery in the
neck may cause a stroke. Investigation
is by duplex ultrasound. If a
patient has recovered from a stroke, or has had a mini-stroke an operation would
be recommended if they have a severe (>70%) narrowing of the internal carotid
artery.
Hyperhidrosis of the palms is treated by
an operation to divide the nerves that control sweating.
This is done by passing a telescope into the chest and is called
thorascopic sympathectomy.
For patients with mainly excessive
sweating of the armpit, the treatment is injection of botulinum toxin into the
skin of the armpit. This lasts
about 6-9 months and can then be repeated.