Vascular Insufficiency

Vascular Insufficiency (or Inadequate circulation) may affect either the blood vessels moving blood away from the heart (arteries) or the blood vessels returning blood back towards the heart (veins). 

Arterial Insufficiency is generally the more serious condition.  This is arterial blood carries oxygen and nutrients out to the bodies tissues.  So without blood flow, the body cannot function properly.  Arterial insufficiency can lead to pain with activity, pain with rest, infection, gangrene, even death. 

Diminished arterial circulation is seen most commonly in smokers and diabetics and in the elderly. 

Circulation can be tested using a variety of specific testing methods.  One simple tool is a Doppler (pictured on the right).  This sophisticated machine is able to test blood flow in the arteries simply by placing a probe on the skin, completely non-invasively. 

A Photoplethysmograph (PPG) uses a different sort of probe to test the smallest of blood vessels known as capillaries--again painlessly. 

Koven's SmartDop-20

Normal Doppler waveform.

We can also test blood flow by assessing blood pressures at different levels (arm, ankle, toe, e.g.) and doing comparisons in how the blood pressure varies at different levels.   

Diabetics, smokers, and the elderly may need to have these tests performed as a screening measure.  (The Achilles Foot Health Centre is equipped to perform all these tests in our facility.)

Occasionally, other testing needs to be performed.  This additional testing may include, for example,  injecting dye into the blood vessels and doing special X-rays to look at the arteries.  This is typically done when simpler tests show diminished circulation and we need to know the level of blockage in order to correct the condition. 

Diminished arterial circulation may be treated with changes in lifestyle, medications, and surgery.

Venous Insufficiency is generally less serious than arterial insufficiency.    Poor vein function means that the blood tends to pool in the legs (swelling).  This is frequently indicative of poor valve function in the veins or certain conditions of the heart.

Vascular testing similar to that done to test the arteries may be performed for the veins as well.  

Treatment may include simple compressive stockings to help push accumulating fluids up and out of the legs, medications to help the patient excrete excess fluids, or surgery.



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The Achilles Foot Health Centre
S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
Dr. S. A. Schumacher, Podiatric Corporation  

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