Timely vascular care can save limbs

In an interview with Manav Mander, Dr Pranay Pawar, Head of the Vascular Surgery Unit at CMC, highlighted the growing burden of vascular diseases in India.

Dr Pranay Pawar emphasised that common but serious conditions like diabetic foot, varicose veins, vascular access for dialysis and peripheral arterial disease (PAD) can lead to severe complications, including limb loss, if not treated in time.

Role of vascular surgeons

Vascular surgeons are specialists who diagnose, manage and treat conditions affecting the body’s blood vessels—excluding those of the heart and brain. As lifestyle-related diseases such as diabetes and hypertension increase in prevalence across India, the role of vascular surgeons is becoming increasingly vital in the healthcare system.

Diabetic foot

Diabetic foot is one of the major health challenges in India due to the rapidly rising diabetic population. Complications from diabetic foot can result in severe infections, gangrene, and even amputations, if not managed properly.

Vascular surgeons are crucial not only in treating these complications but also in preventing them. Diabetic foot encompasses a range of issues such as ulcers, infections, and amputations, often caused by nerve damage and poor circulation.

High blood sugar levels can lead to nerve damage (diabetic neuropathy) and vascular damage in the feet, increasing vulnerability to injuries and infections.

Varicose veins

Varicose veins are twisted, swollen veins that appear on the surface of the skin, commonly on the legs.

While often dismissed as a cosmetic issue, they can lead to pain, itching, swelling and a feeling of heaviness. If neglected, varicose veins can progress to more serious vascular complications.

Vascular access

With an increasing number of kidney disease cases in Punjab, there is a high demand for dialysis.

For effective dialysis, vascular access through fistulas or permcath insertions is essential. Unfortunately, many patients delay seeking proper treatment and undergo procedures by untrained technicians, leading to poor outcomes.

Dr Pawar stresses the importance of these procedures being carried out by qualified vascular surgeons to ensure safety and efficacy.

Peripheral arterial disease

PAD is a circulatory disorder where narrowed arteries reduce blood flow to the limbs, often causing pain, numbness, and difficulty walking.

It is becoming increasingly common in India, especially among individuals over 50, diabetics, smokers, and those with uncontrolled hypertension and cholesterol levels. Symptoms such as cramping or pain in the legs while walking (intermittent claudication), coldness in the feet or legs, shiny skin, hair loss, and non-healing wounds often go unnoticed or are mistaken for signs of aging or arthritis.

By the time patients seek help, PAD may have advanced significantly. India-specific risk factors include widespread diabetes, smoking, sedentary lifestyle, lack of awareness, absence of routine screenings, and limited access to vascular care in rural areas.

Dr Pawar underlines the critical role vascular surgeons play in diagnosis, evaluation, and revascularisation procedures. “We regularly perform multiple procedures a week to treat these patients who come from all over Punjab,” he shares. Unfortunately, many patients delay treatment until complications arise, leading to more invasive procedures like amputations.