Unusual Vascular Conditions

At NewYork-Presbyterian, our vascular specialists have the expertise to treat a full range of vascular disorders, including rare and unusual vascular conditions. We offer advanced noninvasive diagnostic tests, minimally invasive treatment options, and prevention strategies.  Combined with the latest technologies and the vast resources available at our two renowned medical centers – NewYork-Presbyterian/Columbia University Irving Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center – you'll receive the best possible care for your vascular health and quality of life.

Unusual Vascular Conditions We Treat

Raynaud phenomenon

This is a type of peripheral vascular disease in which the smallest arteries that bring blood to the fingers or toes tighten when exposed to cold or during emotional upset. It most commonly occurs in women between the ages of 18 and 30. Symptoms include cold, pain, and paleness in the fingertips or toes. Risk factors include certain connective tissue disorders and autoimmune diseases, smoking, drinking alcohol, and infection with the bacteria Helicobacter pylori (H. pylori).

Treatment may include preventative measures such as wearing gloves, avoiding cold weather, smoking cessation, reducing trauma when possible, and taking certain medications.

Thoracic outlet syndrome

Thoracic outlet syndrome causes shoulder, neck, and arm discomfort that occurs when nerves or blood vessels near the collarbone get pinched or compressed. The affected area becomes pale and cool, and tingles, aches, or feels numb. The pulse is weak or absent.  Risk factors include poor posture, obesity, weak shoulder muscles, injury, and activities in which a person repeatedly raises or holds his or her arms overhead.
Doctors treat thoracic outlet syndrome with exercise and physical therapy to strengthen chest muscles, restore normal posture, and enlarge the area through which the blood vessels and nerves pass. Non-steroidal anti-inflammatory drugs can relieve pain. If the problem persists, vascular specialists may recommend surgery to relieve the compression on the artery or vein and can also treat any associated blood clots.  In some cases, the vascular surgeon may need to replace a damaged portion of the blood vessel with a graft—either from elsewhere in the patient's body or an artificial graft.

Marfan's syndrome

Marfan's syndrome is a genetic disorder of the connective tissues that can affect the skeleton, eyes, heart, or blood vessels. People with Marfan's syndrome are at risk of developing a bulge in a weakened spot in the aorta, the main blood vessel that carries blood from the heart to the rest of the body; this bulge is called an aneurysm. An aneurysm or dilation makes the aorta prone to dissection (tearing) or rupture, which can be fatal.  Marfan syndrome usually develops in people with a family history of the syndrome. In up to a third of cases, though, the disorder appears spontaneously, in those without a familial link.

Vascular specialists follow people with Marfan's syndrome regularly, using tests including echocardiograms to evaluate the size of the aorta. Drugs such as beta-blockers can help decrease stress on the aorta by managing underlying heart problems.

• The NewYork-Presbyterian/Columbia University Irving Medical Center Marfan Clinic offers comprehensive care for people with Marfan's syndrome, with a multidisciplinary team coordinating care with other Columbia physicians.

• NewYork-Presbyterian/Weill Cornell's Maurice R. and Corinne P. Greenberg Division of Cardiology is a major center for patients and families with Marfan syndrome and related disorders, such as familial aortic aneurism and mitral valve prolapse, where they receive expert monitoring and treatment.

Fibromuscular dysplasia

In people with fibromuscular dysplasia, cells in the walls of arteries develop abnormally, causing the vessels to narrow or bulge. The condition often develops in the carotid arteries, the two blood vessels in the neck that carry blood to the brain. It can also affect the arteries within the brain, and those that supply the kidneys with blood. As the arteries narrow, blood flow to the brain is reduced or blocked, sometimes causing a stroke or mini-stroke. Symptoms of fibromuscular dysplasia include high blood pressure, dizziness, headache, ringing in the ears, weakness or numbness in the face, neck pain, or changes in vision. Fibromuscular dysplasia develops most often in women ages 14 to 50. Smoking and certain medications can worsen fibromuscular dysplasia.

Vascular specialists treat mild cases of fibromuscular dysplasia with antiplatelet therapy such as aspirin or anticoagulants and pain medication for headaches. If the narrowing is more severe treatment may include angioplasty, arterial stents, and surgery to treat aneurysms.

Buerger disease

Buerger disease (thromboangiitis obliterans) is a chronic inflammatory disease in the arteries. It leads to blood clots in the small- and medium-sized arteries of the arms or legs, eventually blocking them. This disease most commonly occurs in men between the ages of 20 and 40 who smoke cigarettes. Symptoms include pain in the legs or feet, clammy cool skin, and a diminished sense of heat and cold. The only treatment for Buerger disease is to stop smoking.

Scleroderma

Scleroderma (also called systemic sclerosis) is a chronic, degenerative disease that causes blood vessel abnormalities as well as joint, skin, and internal organ problems. Symptoms include thickening and swelling of the tips of the fingers; Raynaud phenomenon; joint pain; taut, dark skin on the face; spider veins; scarring of the skin on the fingers, wrists, or elbows causing immobility; and heart failure and abnormal heart rhythms. Scleroderma usually arises from a combination of genetic and environmental factors. The condition is four times more common in females than males and is most common between the ages of 30-55 years old.

Treatment may include anti-inflammatory medications or corticosteroids, penicillamine, a drug used to treat patients with rheumatoid arthritis, immunosuppressive medications, and physical and occupational therapy and exercise.

• NewYork-Presbyterian/Weill Cornell vascular specialists are collaborating with colleagues at the Hospital for Special Surgery in its Scleroderma, Vasculitis and Myositis Center of Excellence in investigator-initiated trials in scleroderma and vasculitis, and multicenter-sponsored trials of novel agents for these important diseases.

Why Choose Us

Expertise in Vascular Care

NewYork-Presbyterian is a leader in the field of vascular care, with a long tradition of expertise, innovation, and leadership. Our vascular specialists are board certified in vascular or endovascular medicine, cardiovascular disease, and interventional cardiology. They have expertise in diagnosing and treating abnormalities of the vascular/circulation system, including diabetes-related vascular disorders, offering the highest level of specialized care and advanced therapies. Our vascular specialists are internationally known for the treatment of these conditions using minimally invasive therapies.

Individualized and holistic care

At NewYork-Presbyterian, our vascular specialists offer individualized and holistic care, tailoring your treatment to your medical history, lifestyle, and wellness goals. Our goal is to understand your condition and then treat it in a way that improves your lifestyle and prevents future vascular problems. We work closely with our patients and referring physicians to coordinate a personalized treatment plan for every patient. We are especially skilled in diagnostic imaging, vascular medicine, and minimally invasive procedures that allow for shorter and less painful recovery times.

Multidisciplinary team approach

Vascular conditions can affect many areas of the body and may require input from other specialists. Our physicians collaborate with other world-renowned experts at NewYork-Presbyterian, ensuring that you receive the care you need. Your healthcare team may include vascular and endovascular specialists, surgeons, cardiologists, and other specialists.

Propelling the field through research

At NewYork-Presbyterian, our vascular specialists have experience with even the rarest and most complex vascular conditions. Our patient volume allows us to conduct clinical trials of the newest vascular therapies. In fact, the most advanced therapies are often available at our program before other centers in the country, and at times, the world. We continue to drive research into innovative and groundbreaking potential treatments.