The vascular system, also known as the circulatory system, plays an essential role in circulating blood throughout the body, ensuring that oxygen and nutrients reach organs, muscles, and tissues.

Vascular disease is a common problem in the United States. Conditions include problems with arteries (that carry oxygenated blood from the heart), veins (that bring blood back to the heart from the body), and capillaries (the tiny blood vessels between arteries and veins that distribute oxygenated blood to your cells), as well as disorders that affect blood flow.

“The general approach to vascular care in Colorado is unique, as people here tend to have much more active lifestyles and lower rates of smoking,” said Dr. David Feuer, a vascular surgeon and endovascular interventionalist with CommonSpirit Health, a graduate of Vassar College and SUNY Downstate Medical Center College of Medicine. “As a result, the types of atherosclerotic vascular problems we see often develop later in life and can present differently. A fair amount of the vascular disease we encounter here can be due to functional abnormalities of the arteries, rather than true atherosclerotic disease.”

Such was the case recently, when Dr. Feuer treated a 35-year-old man without typical risk factors for vascular disease who sought care after having numbness in his feet while out hiking. CAT scans showed an arterial blood clot needing removal. During the process of dissolving the clot and opening the vessels, an unusual anatomical arterial abnormality was found in his knee. Following more imaging to determine if this was atherosclerotic disease or something else, Dr. Feuer performed a surgical exploration behind the knee that showed muscle and tendon constriction of the artery there. The diseased segment of the artery was surgically removed and a bypass using a piece of his leg vein to replace the damaged segment performed.

Millions of Americans are affected by peripheral vascular disease, which has multiple risk factors, including tobacco abuse, high cholesterol, hypertension, diabetes, and family history. A sedentary lifestyle and poor dietary habits further exacerbate these conditions. Age is another factor, with the risk increasing significantly after age 50.

“Different types of vascular diseases are typically named for their anatomical location,” said Dr. Danielle Smith, a vascular and endovascular surgeon, who completed her vascular and endovascular training at New York-Presbyterian Hospital. She and Dr. Feuer are part of the multidisciplinary team at Colorado Vascular Associates in Colorado Springs who deliver patient-centered care while providing a wide spectrum of treatment for vascular disease. “Peripheral Artery Disease, where the arteries in your legs become narrowed, can lead to poor blood flow and leg pain when walking. Carotid Artery Disease affects the arteries in your neck that supply blood to the brain, which can increase your risk of stroke,” continued Dr. Smith.

“An aneurysm, a weak spot in a blood vessel, can bulge and potentially rupture. Deep Vein Thrombosis occurs when a blood clot forms in a deep vein, often in the legs. If the clot travels to your lungs, it can cause a life-threatening Pulmonary Embolism. Varicose veins, swollen, twisted veins that often appear in the legs, can worsen and lead to Chronic Venous Insufficiency, where blood does not flow back to the heart properly. Another condition, Raynaud’s disease, causes small blood vessels in the fingers and toes to narrow suddenly, often in response to cold or stress, which can make them feel numb or turn white or blue,” she concluded.

The collaboration of many medical professionals at Colorado Vascular Associates includes cardiothoracic surgeons and interventional cardiologists, who utilize both minimally invasive and open surgical approaches. The overlapping expertise allows the team to handle a wide range of complex vascular cases, tailoring their approach for each individual patient. The CVA team is also working closely with orthopedic surgeons, podiatrists, and wound care specialists in the community to help patients with lower extremity arterial vascular disease stay functionally mobile and avoid amputation or tissue loss.

Among the wide range of treatment options for vascular disease at Colorado Vascular Associates, is TEVAR (Thoracic Endovascular Aortic Repair), and EVAR (Endovascular Aneurysm Repair). Both minimally invasive procedures offer significant advantages over traditional open surgery, such as less pain, reduced blood loss, and less scarring, along with a faster recovery time, and a shorter hospital stay.

Dr. Feuer notes: “EVAR requires continuous lifelong monitoring with imaging, while TEVAR follow-up is also lifelong. It is best done with CAT scans of the chest and abdomen, or MRI angiography at least annually.”

“Regular follow-up visits are important to ensure the repair is stable and to catch any issues early,” said Dr. Smith.

Think you might have vascular disease?

In many cases, vascular disease can be completely asymptomatic, while some people may have warning signs that could include:

• Pain, numbness, or weakness in the limbs
• Coldness or color changes in the hands or feet (especially if one-sided)
• Swelling or throbbing near a vein
• Non-healing wounds on the extremities
• Fatigue and cramping during activity that improves with rest

Vascular disease can often be screened for with minimally invasive testing, including duplex ultrasound for the carotid arteries, abdominal ultrasound to evaluate for aneurysmal disease or blocked arteries within the abdomen, and simple blood pressure testing at the ankles to assess whether the blood pressure there is the same as it would be in both arms.

If these screening tests detect significant vascular disease that requires treatment, further imaging with CT angiography of the vascular area of concern may be performed to assist with a treatment plan.

Tips for improving vascular health

Avoid tobacco use in any form, including cigarettes, cigars, vapes, nicotine patches and nicotine gum. Dr. Feuer and Dr. Smith say that this is the single greatest risk factor for the progression of vascular disease.

• Eat a healthy diet that is rich in lean protein, fruits, and vegetables, with limited fat and fried foods.
• Exercise regularly, aiming for at least 30 minutes of walking every day. Muscles need to move; hearts need to pump!
• Maintain a healthy weight
• Manage stress
• Schedule regular health screenings
• Manage existing conditions like high blood pressure, high cholesterol, and diabetes with appropriate medications and dietary habits under the care of a physician.

“Vascular disease develops over the course of a lifetime,” said Dr. Feuer. “Your 60-year-old self would thank your 10-year-old self if you learned to eat healthy and lead an active lifestyle as a child.”

“While you can’t change the genes you inherit, you can reduce how much those genes affect your health. Lifestyle plays a powerful role in this,” Dr. Smith said. “Even though you may be born with certain risk factors, your daily choices — what you eat, how active you are, and how well you care for your body — can have a substantial impact on long-term health.

Care at CommonSpirit is inspired by faith, driven by innovation, and powered by humanity. Learn more at www.mountain.commonspirit.org.