‘Regular screening can help prevent most vascular diseases’

Dr Luv Luthra, a surgeon, talks to Manav Mander about common vascular diseases and the available treatments.

n What are some common vascular diseases?

Vascular diseases are categorised into venous and arterial. Venous diseases include varicose veins, deep vein thrombosis and superficial vein thrombosis. Arterial diseases include peripheral artery disease (blackening of the toes due to a lack of blood supply), thoracic and abdominal aneurysms, diabetic foot, mesenteric ischemia, acute limb ischemia (sudden stoppage of blood in leg or arm) and carotid artery disease.

n What are risk factors for vascular diseases?

Diabetes, obesity, hypertension, coronary artery disease, old age, use of tobacco, smoking and jobs that need people to sit or stand for prolonged durations.

n What is the role of vascular surgeon?

A vascular surgeon treats patients with medical management, open bypass surgeries of vessels of the legs and abdomen and endovascular (angioplasty and stenting of the leg vessels).

n What is the most common cause of amputation?

Diabetes is one of the most common causes. Diabetic patients with uncontrolled sugar levels are prone to infections. Unfortunately, they have diabetic angiopathies which means there is a decreased flow of blood to their legs. This problem goes unnoticed which is why wounds don’t heal and these patients end up needing amputations.

n What is the role of vascular surgeon in dialysis dependent patients?

A vascular surgeon is a qualified doctor to manage these patients. These patients are dependent on dialysis till they undergo renal transplant. We are the only certified and trained surgeons to make fistula for such patients. In case patients have a failed fistula or poor veins we carry out arteriovenous (AV) grafts, basilica vein transposition and even insert permanent catheters, depending on the need of the patient.

n What exactly are varicose veins, and why do they occur?

Varicose veins are enlarged, twisted veins that usually appear on the legs and feet. They occur when the valves inside the veins weaken or fail, causing blood to pool instead of flowing smoothly back to the heart. Factors like prolonged standing, pregnancy, obesity and genetics can all contribute. While often dismissed as cosmetic, they can signal deeper circulatory issues.

n When should someone seek medical attention for varicose veins?

If the veins become painful, swollen, or start causing skin changes—like discoloration, itching, or ulcers—it’s time to consult a specialist. Even without severe symptoms, chronic heaviness or fatigue in the legs can affect quality of life. Early intervention can prevent complications like deep vein thrombosis or venous insufficiency.

n Varicose veins is a common problem, do all patients need surgery?

Yes, we see a lot of patients with varicose veins. But all patients do not need intervention. If diagnosed at an early stage, we give patients compression stockings and advice life style modification such as exercising, walking and reducing weight. For some patients, who have hugely dilated veins, venous ulcer or are at the risk of developing clots, laser treatment is recommended.

n How is a vascular surgeon different from other specialists in treating varicose veins?

A vascular surgeon is trained to do ultrasound-guided procedures. So we treat our patients with either laser, radiofrequency ablation or venaseal under ultrasound guidance. We see and treat. That is the biggest reason that recurrence rates are rare with our technique.

n What is the best treatment for gangrene of foot or hands?

These patients are managed with angioplasty and stenting or even open bypass surgery. Gangrene or peripheral vascular diseases are very common. One of the common causes of amputation. But these can be prevented by treating the blockages and once the disease is treated, amputation can be prevented.

n Your advice to share to prevent vascular diseases?

Stop smoking and consuming tobacco, exercise regularly, eat healthy, keep diabetes and hypertension in check and focus on losing extra weight. In case you have any of the above problems or any kind of family history of diabetes, hypertension and heart disease, meet your vascular surgeon. Prevention and regular screening can save you from most of vascular diseases.