Vascular disease refers to conditions that affect the blood vessels (arteries and veins) that pump blood throughout the body. Arteries carry oxygen-rich blood from the heart to every part of the body, including the brain, kidneys, intestines, arms, legs, and the heart itself. Veins return blood back to the heart. Like the coronary arteries in the heart, blood vessels in other parts of the body can become clogged and hardened from atherosclerosis, the build-up of fatty deposits (plaque) in the arteries. Sometimes they can weaken and even burst.
At MMC, we diagnose and treat the full range of vascular disease:
- Abdominal aortic aneurysm (AAA)
- Aortic dissection
- Buerger’s disease
- Carotid artery disease
- Critical limb ischemia (CLI)
- Chronic venous insufficiency (CVI)
- Congenital vascular malformation (CVM)
- Deep vein thrombosis (DVT)
- Fibromuscular dysplasia
- Mesenteric artery disease
- Peripheral artery disease (PAD), also called Peripheral vascular disease (PVD)
- Pulmonary embolism
- Portal hypertension
- Post-thrombotic syndrome (PTS)
- Raynaud’s disease
- Renovascular hypertension (RAS)
- Thoracic aortic aneurysm (TAA)
- Varicose veins
At MMC, our expert team works together to provide the best possible treatment for patients with vascular disease. These treatments can include lifestyle changes and medication to control risk factors, minimally invasive endovascular therapy and surgery. The treatment approach depends on how severe your symptoms are, how much narrowing or blockage there is in your blood vessels, and your overall health. The treatment options include:
Lifestyle changes – Smoking, high cholesterol, high blood pressure, an inactive lifestyle, and having diabetes all increase the risk of vascular disease getting worse and the possibility of a heart attack or stroke. MMC provides extensive resources for quitting smoking, dietary/nutrition counseling, managing cholesterol levels, medically supervised exercise, and guidance for achieving glucose (blood sugar) control for people with diabetes.
Medications – People with vascular disease often benefit from medications that help reduce the risk of heart attack and stroke. These medications include drugs to help prevent blood clots, cholesterol-lowering medications, drugs to help control blood pressure, and certain vitamins and dietary supplements. At MMC, a medical treatment plan is tailored to the individual needs and risk factors of each patient, and patients are carefully monitored over time.
Thrombolytic therapy is the use of thrombolytic (clot-busting) drugs to dissolve a blood clot without surgery.
Endovascular therapy refers to treating a problem from inside the blood vessel, using minimally invasive, catheter-based techniques.
Angioplasty is a minimally invasive, non-surgical procedure that can be used to widen narrowed or blocked arteries.
Endovascular abdominal aortic aneurysm (AAA) repair is a technique in which a team led by a vascular surgeon and interventional radiologist repairs the aortic aneurysm.
Carotid stenting is a procedure to increase the flow of blood blocked by plaque (a build-up of fatty material on the inside of the artery).
Vena cava filter placement helps prevent blood clots from traveling to the lungs (pulmonary embolism).
Endarterectomy is the surgical removal of fatty deposits (plaque) from the walls of the arteries.
Carotid endarterectomy is the most common non-cardiac vascular procedure performed nationwide. This operation helps prevent a stroke and transient ischemic attacks (TIAs) by restoring blood flow to the brain.
Peripheral endarterectomy is performed to restore blood flow to the lower extremities (legs and feet).
Lower extremity grafting or bypass may be necessary if the narrowing involves a long portion of an artery in the abdomen, groin or lower extremities (legs and feet), bypass surgery. There are three major types of bypass procedures to treat peripheral vascular disease:
- Aortobifemoral bypass surgery is used to bypass diseased large blood vessels in the abdomen and groin.
- Femoral-tibial bypass surgery (also known as infra-popliteal reconstruction) is used to bypass diseased blood vessels in the lower leg or foot.
- Femoropopliteal (fem-pop) bypass surgery is used to bypass diseased blood vessels above or below the knee.
Open aortic aneurysm repair is performed when there is bleeding inside the body from an abdominal aortic aneurysm. Surgery also is usually recommended for patients who have aneurysms larger than 2 inches and those that are growing quickly, with the goal of performing surgery before complications or symptoms develop.
Lower extremity amputation – Surgical removal of the lower limb becomes necessary when advanced peripheral vascular disease (PVD) leads to leg ulcers that will not heal and gangrene occurs. MMC not only provides expert surgical services but also careful planning for rehabilitation and a return to independence.
Varicose vein treatment – Varicose veins are twisted, enlarged veins near the surface of the skin, and are most common in the legs and ankles. While varicose veins usually aren't a sign of a serious problem, in some cases they can indicate a blockage in the deeper veins, a condition called deep vein thrombosis (DVT), which often requires treatment. Several treatment options for varicose veins are available at MMC.
Wound care – With peripheral vascular disease (PVD), poor circulation caused by atherosclerosis (the build-up of fatty deposits in the arteries) can lead to leg ulcers, wounds or open sores that will not heal or keep returning. At MMC, we have specialists in wound care who provide treatment to protect the skin’s surface, prevent new ulcers, and monitor the signs and symptoms of infection that may involve soft tissue or bone.
Clinical trial access – MMC participates in a variety of clinical trials to study new and improved medications, devices and surgical techniques, giving patients with vascular disease access to innovative treatment options that are not available anyplace else in Maine.