Angiology and Vascular Surgery at UPMC Salvator Mundi International Hospital

The angiologist specializes in the diagnosis, prevention, and non‑invasive treatment of diseases of the vascular system—meaning veins, arteries, and lymphatic vessels—primarily using conservative and pharmacological therapies. The main conditions treated by an angiologist include:

• Chronic venous insufficiency.
• Deep vein thrombosis (DVT).
• Lymphedema.
• Varicose veins.

The vascular surgeon, on the other hand, intervenes when surgical or minimally invasive treatment is required, for example:

• Angioplasty with stent placement to widen narrowed arteries.
• Removal of varicose veins using laser, radiofrequency, or sclerotherapy.
• Procedures for aneurysms, stenosis, and other complex circulatory conditions.

An angiology consultation is recommended when symptoms appear that may indicate problems with the circulatory system, such as:

• Cold or numb hands and feet.
• Swelling, pain, or heaviness in the limbs.
• Visible varicose veins or spider veins.
• Wounds that do not heal.

It may also be prescribed for the evaluation and monitoring of an already diagnosed vascular condition.

Even in the absence of symptoms, an angiology consultation is recommended as a preventive screening for individuals who:

• Are current or former smokers.
• Have a family history of vascular diseases.
• Are over 50 years old.
• Have hypertension and/or diabetes.

Doppler and Color Doppler ultrasounds are non‑invasive, quick, and painless diagnostic tests used to evaluate blood flow within arterial and venous vessels. The procedure is very similar for both, but they differ in how the images are displayed.

• With Doppler ultrasound, blood flow is shown in black and white, in a two‑dimensional format.
• With Color Doppler ultrasound, the images include a color map that highlights the direction and speed of blood flow, providing a more detailed visualization.

Both tests are essential for diagnosing conditions such as vascular narrowing (stenosis), occlusions, venous insufficiency, and thrombosis.

Peripheral artery disease may initially be asymptomatic or present with mild discomfort. In more advanced stages, however, it can cause more severe symptoms that compromise the function of the affected limb. The most characteristic symptom is intermittent claudication: muscle pain in the legs that appears during physical activity (walking or exertion) and improves with rest. The intensity can range from mild discomfort to limiting pain.

Other possible signs and symptoms include:

• Changes in the color and temperature of the limb.
• Erectile dysfunction in men.
• Numbness or weakness in the affected limb.
• Thinner, shinier skin, with slowed hair and nail growth.
• Ulcers or skin lesions in advanced stages.

The diagnosis of lower‑limb lymphedema is primarily clinical and is based on medical history, physical examination, and limb‑volume measurement. It can be supplemented with imaging tests such as lymphoscintigraphy, Magnetic Resonance Imaging (MRI), or ultrasound.

Treatment options for lymphedema vary depending on the severity of the condition. The conservative approach, known as decongestive therapy, includes a combination of:

• Compression bandaging.
• Specific physical exercises.
• Skin care and hygiene to prevent infections and other complications.
• Manual or mechanical lymphatic drainage.
• Use of compression stockings.

When these measures are not sufficient, microsurgery may be considered – for example, lymphatic‑venous bypass, which helps resolve lymphatic congestion and restore lymphatic circulation in the affected limb.

Yes, cardiac arrhythmias can be closely linked to vascular diseases. Certain cardiovascular conditions—such as myocardial infarction, arterial hypertension, and atherosclerosis—can reduce the oxygen supply to the heart muscle or alter the structure of the heart. These factors may promote changes in the electrical pathways that regulate the heartbeat.

As a result, vascular diseases can directly contribute to the development of several types of arrhythmias, including:

• Atrial fibrillation.
• Ventricular tachycardias.
• Other rhythm disorders that make the heartbeat irregular or less effective.

No, varicose veins and venous insufficiency are not the same, although they are closely related.

• Varicose veins are dilated, twisted veins that are especially visible on the legs. They often develop due to malfunctioning venous valves, which impair proper blood flow back to the heart and cause blood to pool in the vessels, making them more prominent under the skin.
• Venous insufficiency is a condition in which the veins lose their ability to transport blood efficiently, leading to blood stasis—especially in the lower limbs. Common symptoms include leg swelling and heaviness, pain or itching, and, in more advanced stages, venous ulcers.

In summary, varicose veins can be a sign of venous insufficiency, but venous insufficiency can also occur without the presence of varicose veins.

The term aneurysm comes from ancient Greek and means “dilation”. In medicine, an aortic aneurysm refers to a permanent and abnormal enlargement of a section of the aorta, the largest blood vessel in the body.

This dilation weakens the artery walls, making them thinner and at higher risk of rupture. The most common site is the abdominal aorta, which accounts for about 80% of cases. Less frequently, aneurysms can develop in the thoracic aorta.

An aortic aneurysm is a potentially very serious condition because a rupture can cause severe internal bleeding, which is almost always fatal.