What Is Small Vessel Disease?

Vascular disease (diseases of blood vessel) mainly refers to atherosclerosis, inflammatory vascular disease, functional vascular disease, and true tumor disease of blood vessels. Among them, atherosclerosis is the most common.

Vascular disease

Vascular disease concept

Classification of vascular diseases

There are mainly the following classifications

Vascular diseases are classified according to the consequences of pathological changes

Various types of primary vascular diseases can be divided into three categories

Atherosclerosis :

The blood vessel wall loses elasticity due to the lesion, becomes weak, and expands under long-term pressure, resulting in hemangio-like lesions, and even rupture and bleeding.

The lesions narrowed the lumen, followed by ischemia and necrosis of the donor organ or limb.

Lesion causes intravascular coagulation and thrombosis after vascular intimal injury, and then organ or tissue ischemia occurs; or the distal lumen is blocked after emboli fall off.

Vascular diseases are classified by etiology and pathological changes

Primary vascular diseases can be divided into six categories:

Degenerative degenerative vascular disease. Atherosclerosis, arteriosclerosis, arteriosclerosis (hyperarteriosclerosis, proliferative arteriosclerosis).

Inflammatory vascular disease. Infectious arteritis, syphilitic arteritis, giant cell arteritis, thromboocclusive vasculitis, rheumatoid arteritis.

functional vascular disease. Raynaud's disease, cyanosis in hands, feet, and erythema.

Congenital vascular disease. Congenital aneurysms, congenital arteriovenous fistulas, various types of congenital vascular tumors (capillary hemangiomas, cavernous hemangiomas, and hemangiomas).

Traumatic vascular disease. Traumatic aneurysms (including pulsatile hematomas and postoperative anastomotic hemangiomas), traumatic arteriovenous fistulas.

tumor vascular disease. Hemangiosarcoma, hemangioendothelial cell tumor, hemangiopericytoma.

Common diseases of vascular disease

The cause of death from human diseases is close to the first. Although it extensively invades various types of arteries, the aorta, coronary arteries, carotid arteries, and cerebral arteries are the main affected areas, so myocardial infarction and cerebral infarction become the main consequences of this vascular disease.

The development of antibiotics has significantly reduced the incidence of infectious and syphilitic arteritis. The main cause of aneurysms in large and medium arteries is also atherosclerosis. Therefore, atherosclerotic vascular disease has become the main diagnosis and treatment target of internal medicine and surgeons in the cardiovascular specialty.

In the case of inflammatory vascular diseases, the incidence of infectious and syphilitic arteritis has fallen sharply at the end of the 20th century, so it has become more clinically important. It mostly invades the blood vessels of the lower limbs of men. Smoking is closely related to its onset, and some conditions can stop progressing after quitting.

The most common form of functional vascular disease is Raynaud's disease. More common in young women, upper limb involvement is more. It showed paroxysmal bilateral fingertips, and then turned into bruises and flushes. In case of cold, it can be relieved after warming, and it is rare to develop gangrene due to ischemia. Most patients respond to vasodilator drugs and sympathectomy.

Vascular neoplastic diseases are rare and often included. The site of the disease is extensive, which can occur in the limbs, trunk, and internal organs of the body cavity. Therefore, the diagnosis can only be made after surgical resection. Surgical resection in early patients can be cured.

Vascular disease pathology

Except for true vascular tissue tumors and a few congenital vascular diseases, the basic pathological changes of a variety of vascular diseases, whether organic or functional, are stenosis (organic or spasmodic) of the vascular cavity, or occlusion of the organ (heart , Brain, kidney, intestine, limbs, etc.) suffer from ischemic changes (acute or chronic). Some vascular diseases show limited expansion to tumor-like lesions. Once the aneurysm is formed, it gradually expands, and most of them are at risk of sudden rupture and death without treatment.

Vascular disease treatment

Should mainly reduce the incidence of atherosclerotic vascular disease, advocate and promote smoking cessation campaigns, guide the population to take a low-fat diet, and for patients with early arteriosclerosis, use lipid-lowering drugs and vasodilator drugs to slow or Stop disease progression.

When there is significant ischemia of organs or limbs or tumor-like lesions in blood vessels, surgery is needed. Advances in diagnostic and surgical techniques of vascular surgery and the development of intensive care medicine since the 1960s have made aneurysms, coronary arteriosclerotic heart disease, extracranial carotid artery occlusive disease, traumatic vascular disease, cerebral infarction, acute mesenteric artery The treatment of occlusion, acute and chronic limb arterial occlusion has entered a new stage. For tumor-like lesions, resection of the angioplasty is mainly performed, and autologous or vascular grafts are transplanted. There are two main types of surgery for stenosis and occlusive disease: one is percutaneous intraluminal angioplasty, which uses balloon catheters to expand stenotic lesions from the vascular cavity. The advantage of this method is that the surgical injury is light, which can obtain 70 ~ 80% curative effect, and the activity can be resumed 2 to 3 days after surgery: its disadvantage is that restenosis can occur. The other is the establishment of autologous or vascular graft bypass circuits. The preferred operation is autologous vein transplantation, which has the disadvantage that the transplanted vein is also prone to atherosclerosis. Graft bypass grafts have a long-term incidence of 2 to 5% (six to five years after surgery). We are still looking for artificial blood vessels that can prevent infection and pre-implant the vascular endothelium in order to achieve better results.