Disease of arteries can be classified broadly into two categories. These are occlusive and aneurysmal disease of arteries. Occlusive disease of large and medium sized arteries is caused by atherosclerosis which is a condition of the artery wall in which cholesterol is deposited in the layers of the artery wall. An analogous process is the development of rust in a galvanised iron water pipe. In both situations the wall becomes damaged and thickened resulting ultimately in narrowing of the lumen of the tube.

Atherosclerosis in humans is associated with age but can be accelerated by the presence of the following factors: diabetes mellitus , smoking , hypertension , hyperlipidaemia (familial and sporadic) and matters relating to lifestyle. Some of these factors are under the control of the patient , whereas others are best dealt with by your doctor. The following presentations and downloadable documents are designed to help you understand disease of the arteries so that you can be an informed participant in the maintenance of your health.

Arterial occlusive disease of the lower limbs
Exercise Program for the treatment of arterial occlusive disease
Conditions that may be mistaken for arterial occlusive disease

Carotid Endarterectomy

Carotid endarterectomy, combined with best medical management, has been demonstrated in large randomised controlled trials to be the most effective way to prevent stroke and death caused by atherosclerotic disease involving the carotid artery. More recently, procedures involving stenting of the carotid arteries have become available. While carotid artery stenting is less invasive than carotid endarterectomy it has not been demonstrated to be superior in the prevention of stroke from carotid artery disease. The following presentation outlines standard carotid endarterectomy procedure.

Video created and narrated by Dr Raymond Englund

Bypass of the femoral arteryy

The first femoral artery bypasses were performed in France in the 1950’s. These bypasses usually involved the use of autogenous tissue, most commonly with reversed or non-reversed long saphenous vein. They are the gold standard for durability when revascularisation of the lower limb is required in the presence of occlusive femoral artery disease. The following presentation outlines bypassing of the femoral artery using reversed long saphenous vein for the treatment of critical ischaemia of the lower limb.

Renal Artery Angioplasty and Stenting

Arterial occlusive disease can effect the blood supply to the kidneys. When this occurs the result can be high blood pressure and renal failure. Obstruction of the renal arteries by atherosclerosis of the arterial walls can be overcome by angioplasty and stenting of the narrow section of the artery. The below youtube videos demonstrate how arterial stenosis is corrected.

video taken from Youtube

video taken from Youtube