Glossary

Our glossary was designed to help our visitors understand the terms associated with the many types of Vascular Disease

A

Abdominal Aorta: The portion of the largest artery in the body between the diaphragm and the bifurcation into the common iliac arteries (about the location of the belly button or navel.

Abdominal Aortic Aneurysm (AAA): A dilatation or enlargement of the aorta; this occurs when there is weak area in the aorta, the main blood vessel that carries blood from the heart to the rest of the body. As blood flows through the aorta, the weak area bulges like a balloon and can burst if the balloon gets too big.

Aneurysm: A ballooning or bulging of the wall of a vein or artery, usually due to a weakening in the wall or congenital abnormalities.

Aorta: The largest artery in the body, originating at the left ventricle and serving as the primary trunk from which the entire arterial system proceeds.

Arterial insufficiency: An inadequate blood supply in the arterial system most often caused by a narrowing in the vessel proximal to the inadequately supplied area.

Arteriogram: An x-ray used to visualize and determine specific arterial blockages in the body. The procedure involves inserting a small catheter into the artery that injects dye. Usually the femoral artery in the groin is used.

Atherosclerosis: From the Greek words athero (gruel or paste) and sclerosis (hardness). The process within the arteries where deposits of fatty substances, cholesterol, calcium or fibrin are built up in the inner lining (called plaques).

Arteriosclerosis: A normal consequence of aging where the arterial walls gradually thicken and arterial fibers decline. The arteries become stiff. (see Atherosclerosis)

Artery: A pipeline (blood vessel) carrying oxygen-rich blood from the heart to the rest of the body. When diseased, the organ supplied may become damaged due to lack of oxygen and nutrients. (see ischemia)

Ankle Brachial-Index (ABI) measurement: A non-invasive method for testing for peripheral arterial disease through the use of a Doppler probe and a blood pressure cuff on both the arms and ankles.

Amputation: Surgical removal of a limb or portion of a limb. Above knee, below knee, or partial foot are all varieties.

Angioplasty (balloon): A procedure that dilates or widens arteries narrowed by arterial disease. A catheter with a deflated balloon is threaded through the narrowed artery to the narrowed part and then inflated to break the plaque and expand the artery.

Angioplasty (laser): A procedure that opens arteries clogged or narrowed by arterial disease. A thin tube with a laser tip attached is inserted into the artery. The laser vaporizes the plaque to clear the artery. (This method has yet to be proven effective.)

Antiplatelet: Medication, including aspirin and newer agents used to prevent clumping together of platelets, one of the first things to occur in artery clotting.

Arterial insufficiency: An inadequate blood supply in the arterial system most often caused by a narrowing in the vessel proximal to the inadequately supplied area usually caused by a buildup of plaque.

Ambulatory venous pressure: the blood pressure inside veins while walking, normally very low at 0-20mmHg. due to calf muscle pump action moving blood up the leg when walking. The pressure rises when valves in the veins are damaged and allow blood to flow backward toward the foot – a condition known as venous insufficiency.

Anticoagulation: medication that “thins” the blood to prevent blood clot formation. The medication works by reducing the amount of natural clotting factors made by the liver. Heparin is given intravenously or by subcutaneous injection; warfarin is given by mouth.

B

Blood pressure: The force of blood pushing against blood vessel walls.

C

Calcified vessels: This occurs when an artery becomes hardened from calcium deposits in the wall. Often seen in diabetes. Affects the ability to make accurate blood pressure measurements in the legs.

Catheter: A tiny flexible tube inserted in a blood vessel to inject dye, assist with the removal of a blood clot, or inject medication.

Catheter-based technology: When a catheter is used in minimally invasive procedure, guided through the blood vessels and tracked through the use of a fluoroscope and then displayed on a screen.

Collateral circulation: The slow development of smaller peripheral arteries to allow some blood flow around the narrowed/blocked area of an artery. This occurs as an adaptation when an artery is slowly blocked with plaque over time.

Critical Leg Ischemia: A severe obstruction of the arteries which seriously decreases blood flow to the extremities (hands, feet and legs) and has progressed to the point of severe pain and even skin ulcers or sores. Critical Limb Ischemia (CLI) is often present in individuals with severe peripheral arterial disease (PAD).

Cellulitis: infection of the skin, usually caused by normal skin bacteria that get under the top layer of skin. Signs of infection include red, warm, tender skin, swelling, fever, and/or chills.

Chronic venous insufficiency: pooling of blood in veins at the lower part of the leg due to damaged valves allowing backward flow. Over time, swelling and thinning of skin with discoloration and possible ulcer formation occur due to constant high pressure against the skin.

Collateral veins: small veins that grow around an area of blockage or blood clot.

Compression support stocking: elastic or latex stockings that support the tissue of the leg by putting counter-pressure against the skin, reducing the effects of venous blood pooling. Stockings are usually knee or thigh length and available in varying pressures and colors.

D

Deep vein thrombosis: blood clot in a deep vein of an extremity.

Dermatitis (stasis dermatitis): dry, flaky, itchy skin related to changes caused by venous insufficiency; severe cases may weep clear fluid and resemble infection.

Doppler or duplex ultrasound: a non-invasive test using a Doppler probe and gel; sound waves are reflected off moving structures (blood vessels) to give a picture and the sound of blood flow to identify problems or clots.

Diabetes mellitus: A metabolic disorder in which the body does not produce insulin (type 1) or when the body does not make enough or cannot properly use insulin (type 2).

Doppler: A diagnostic tool that uses low intensity ultrasound to detect blood flow velocity in arteries or veins.

Duplex: A diagnostic tool that combines Doppler and ultrasound.

E

Endovascular Grafting: A minimally invasive procedure for repairing AAA by directing the flow of blood around an aneurysm through the use of a graft. The procedure allows the graft to be delivered through a catheter using x-ray guidance.

Embolous: A clot that develops in a blood vessel and hinders blood flow to the heart.

Embolus/embolism: a blood clot or clot that moved from one location to another, such as from the leg to the lung.

Endarterectomy: The removal of plaque from the inner wall of a diseased artery by surgery.

Exercise Therapy: Exercise therapy for intermittent claudication is an individualized exercise prescription (or plan) designed to restore health and prevent further disease. The prescription, which is written by a doctor or rehabilitation specialist such as a clinical exercise physiologist, physical therapist, or nurse. It takes into account your current medical condition and provides advice for what type of exercise to perform, how hard to exercise, how long, and how many times per week.

F

Femoral artery: The large artery in the leg which extends from hip to knee. Often the bypass grafts start at this point.

Femoral vein: the large, deep vein extending from the groin to the knee.

G

Gangrene: Tissue death caused by poor blood flow. It is usually black with color, often with a foul odor.

Grafts: A surgical technique using man-made material or vein to re-route blood flow.

H

High Blood Pressure: Higher than normal blood pressure – the force of blood pushing against blood vessel walls. One of the contributing factors to AAA.

Homocysteine: An amino acid in the blood. Elevated plasma levels may lead to increased risks of PAD.

Hyperpigmentation: excess skin pigment or color caused by high venous pressure forcing blood cells to leak from small veins under the skin.

Hypertension: When the pressure in the arteries is consistently above the normal range. Also known as high blood pressure.

I, J, K

Insulin: A hormone produced by the pancreas essential for the body’s use of sugars.

Intermittent Claudication: Symptoms that occur when the leg muscles do not receive the oxygen rich blood required during exercise, thus causing cramping in the hips, thighs or calves.

Interventional radiology: A medical specialty where doctors use imaging technologies to diagnose blockages in arteries and also treat them with balloons, stents, and catheter delivered medications.

Ischemia: An organ (heart, brain, kidneys, or foot, for example) that is not getting adequate blood flow and lacks vital oxygen and nutrients.

Iliac vein: large deep vein branching into each leg from the umbilicus (belly button) to the groin.

INR (International Normalized Ratio): blood test used to monitor the effects of warfarin therapy; ideal range while on warfarin is 2.0 – 3.0.  Some patients may require higher or lower ranges depending on other medical conditions.

Klippel-Trenaunay Syndrome: condition characterized by multiple vein malformations in the superficial venous system; abnormally small or absent deep veins, and port-wine stains.

L

Laser therapy: use of a high intensity light beam to eliminate small varicose veins just under the skin surface.

Lipodermatosclerosis: thickening/hardening of normal fatty tissue under the skin due to prolonged effects of high venous pressure.

Lipids: another term for fats that can be broken down into fatty acids.

Lipoproteins: Proteins that transport cholesterol and other fats to and from cells. LDL is the subtype most dangerous for peripheral arterial disease. HDL is beneficial in prevention.

M, N, O

Non-Invasive: Medical procedures or exams which do not involve needles, dye or x-ray to diagnose arterial diseases.

P, Q

Perforator veins: small veins that connect the deep veins to the superficial veins, allowing blood to drain from the skin into the deep veins and then pumped toward the heart.

Phlebitis: inflammation of a vein or segment of vein often associated with a blood clot.

Phlebectomy: surgical removal of a blood clot from a vein.

Popliteal vein: large deep vein behind the knee.

Post-phlebitic syndrome: collection of symptoms that occurs after a blood clot has damaged the veins in the leg: chronic swelling, skin discoloration, pain/achiness, and possible ulcer.

Pulmonary embolism: blood clot in the lung.

Peripheral Artery Disease (PAD): A common disorder that occurs in the artery segments of the circulatory system (legs, pelvis, neck brain). The artery wall linings slowly become narrowed and rough clots formed due to built up cholesterol or plaque. It has major implications on a patient’s life due to association with blockages in the heart and brain with potential for death from heart attack and stroke.

Plaque: The built up material on the inner lining of an artery made up of cholesterol and fatty substances.

R

Reflux: backward flow of blood in a vein; also known as regurgitation.

Rest Pain: Constant pain (particularly at night) found in the toes or foot that is caused by poor blood flow.

Revascularization: Procedures to restore blood flow to the artery.

S

Saphenous (great saphenous) vein: large superficial vein in the leg, from the groin to the ankle.

Saphenofemoral junction: joining of the large deep vein of the thigh (femoral) with the saphenous vein at the groin.

Sclerotherapy: injecting small varicose veins with concentrated salt solution (hypertonic saline; performed in the office.).

Spider veins: a form of varicose veins consisting of small bluish-purple veins often shaped like spider webs clustered on the legs.

Stab phlebectomy: surgical removal of segments of varicose veins through multiple small incisions on the leg; performed in the operating room.

Stripping of varicose veins: surgical removal of varicose veins.

Superficial: under the skin.

Scleroderma: A chronic disease characterized by degenerative changes and scarring in the skin, joints, and internal organs and by blood vessel abnormalities. Often mistaken as Buerger’s Disease.

Smoking Cessation: To quit a smoking habit. Critical aspect of treating Buerger’s disease and Peripheral Artery Disease.

Stents: Wire mesh tubes that are surgical placed within the artery (recently cleared through angioplasty) via a catheter threaded through the artery. It is opened to form a rigid support to hold the clogged artery open to potentially prevent recurrent narrowing.

T

Toe Systolic Pressure Index: A diagnostic measurement taken to determine peripheral arterial disease. Normally used when the Doppler method is ineffective (due to artery calcium buildup), usually in patients with diabetes. This technique uses a special pneumatic cuff placed on the big toe.

Triglycerides: The chemical form in which most fats exist in foods.

Thromboangiitis obliterans: The official medical term for Buerger’s Disease.

Telangiectasia: a type of varicose veins also known as spider veins; small bluish-purple veins, usually found in clusters on the leg.

Thrombosis: blood clot.

Thrombophlebitis: blood clot in a vein that causes local inflammation, pain, and swelling.

Tibial veins: deep veins in the calf.

Trendelenburg test: a method of testing for backward flow of blood in veins.

U

Ulcer: an open wound or sore. A venous ulcer is usually located around the ankle or lower leg and is caused by persistent high pressure in the veins that leads to thinning and destruction of normal skin and subcutaneous tissue.

Unna boot: a roll bandage with zinc oxide in the gauze, which is used to apply counter-pressure to a venous ulcer.

Ultrasound: The diagnostic test using imaging technology to produce sound waves of the images of various tissues. This test is used to locate aneurysms or blocked arteries and can measure their size.

Ultrasonic Duplex Scanning: The diagnostic test for PAD that produces images of arteries or veins on a screen via the use of ultrasound equipment. This test is used to locate blocked arteries or measure their size.

V, W, X, Y, Z

Valve: small, delicate flaps of tissue spaced along a vein that open and close to allow blood to flow up the leg and return to the heart.

Valvular insufficiency: damaged valves that no longer close properly, thereby allowing blood to flow backward down the leg and cause pooling at the ankle and lower leg. (See also “reflux”).

Valvuloplasty: surgical repair of damaged valves in veins.

Varicose vein: enlarged (dilated), elongated, and twisted veins, usually found in the thighs and legs, ranging in size from small spider veins to very large bulging rope-like veins.

Venography: x-ray study of veins using “dye” or contrast solution to outline veins and identify problems.

Venous hypertension: high pressure in veins due to damage to venous system (see also valvular insufficiency) leading to symptoms of chronic venous disease.

VNUS: procedure to close varicose veins with the use of a radiofrequency catheter inserted into the vein. The heat produced by the radiofrequency energy causes the vein to collapse and seal shut. This is also a same day operating room procedure, with expected return to normal activities in 1-2 days.

Vascular Medicine: A branch of medicine that deals primarily in medical treatment of vascular diseases. A rapidly expanding area of modern medicine.

Vascular Nurse: A nurse specializing in caring for patients with vascular disease.

Vascular Surgeon: A physician with a specialty in performing surgery to either remove the plaque from an artery or more commonly to bypass the area of obstruction with a graft. Also can be involved in the medical treatment of vascular disease.

Vessels: The tube like structures in the circulatory system that are responsible for circulating blood within the body. The three kinds of vessels are arteries, veins and lymphatics. Capillaries are the microscopic structures that connect arteries and veins at the tissues.

Veins: Blood vessels that carry the blood from the body back to the heart.