Editing Angiopathy

{{Short description|Disease of the blood vessels}}
'''Angiopathy''' is the generic term for a disease of the [[blood vessel]]s ([[artery|arteries]], [[vein]]s, and [[capillary|capillaries]]).<ref>{{DorlandsDict|one/000005089|angiopathy}}</ref> This also refers to the condition of damage or rupture of small blood vessels. The best known and most prevalent angiopathy is '''[[diabetic angiopathy]]''', a common [[complication (medicine)|complication]] of [[chronic (medicine)|chronic]] [[diabetes]].

==Classification==

===By caliber===
There are two types of angiopathy: '''[[macroangiopathy]]''' and '''[[microangiopathy]]'''.<ref>{{Cite web |title=Medical Definition of Angiopathy |url=https://www.rxlist.com/angiopathy/definition.htm |access-date=2024-10-14 |website=RxList |language=en}}</ref>

In macroangiopathy, [[atherosclerosis]] and a resultant [[blood]] [[clot]] forms on the large blood vessels, sticks to the vessel walls, and blocks the flow of [[blood]]. Macroangiopathy in the heart is coronary artery disease; in the brain, it is cerebrovascular disease. Macroangiopathy may cause other complications, such as [[ischemic heart disease]], [[stroke]] and peripheral vascular disease which contributes to the [[Diabetic foot ulcer|diabetic foot ulcers]] and the risk of amputation.

In microangiopathy, the walls of the smaller blood vessels become so thick and weak that they [[hemorrhage|bleed]], leak [[protein]], and slow the flow of blood through the body. The decrease of blood flow through [[stenosis]] or clot formation impairs the flow of [[oxygen]] to [[cell (biology)|cell]]s and [[biological tissue]]s (called [[ischemia]]) and leads to cellular death ([[necrosis]] and [[gangrene]], which in turn may require [[amputation]]). Thus, tissues which are very sensitive to oxygen levels, such as the [[retina]], develop microangiopathy and may cause [[blindness]] (so-called proliferative diabetic [[retinopathy]]). Damage to [[nerve]] cells may cause peripheral [[neuropathy]], and to [[kidney]] cells, [[diabetic nephropathy|diabetic kidney disease]] (Kimmelstiel-Wilson syndrome).

===By condition===
It is also possible to classify angiopathy by the associated condition:<ref name=":0">{{Cite web |title=Angiopathy: what is it, symptoms and treatment |url=https://www.topdoctors.co.uk/medical-dictionary/angiopathy |access-date=2024-10-14 |website=Top Doctors |language=en-GB}}</ref>
* [[Diabetic angiopathy]]
* [[Cerebral amyloid angiopathy]]

Chronic diabetes can lead to several problems, one of which is Diabetic Angiopathy. Individuals with diabetic angiopathy notice a constriction in their [[Artery|arteries]]. This cause many organs to receive insufficient blood and oxygen, which might eventually cause harm. [[Hyperglycemia|High blood sugar]] is the primary cause of diabetic angiopathy. Excessive blood sugar levels have the potential to harm tissues and cells.<ref name=":1">{{Cite web |last=Australia |first=Bauerfeind |title=Bauerfeind Australia |url=https://bauerfeind.com.au/blogs/diabetes/diabetic-angipathy?srsltid=AfmBOooMhHz8_rFoMDJiyj9e78jLhild4NTl2V4mMNL8Qp2KQL_VDWL- |access-date=2024-10-14 |website=Bauerfeind Australia |language=English}}</ref>

A form of [[Cerebrovascular disease|cerebrovascular illness]] known as Cerebral Amyloid Angiopathy (CAA) is typified by the buildup of [[Amyloid beta|amyloid beta-peptide]] in the leptomeninges and small to medium sized cerebral blood vessels.<ref>{{Cite journal |last1=A |first1=Viswanathan |last2=SM |first2=Greenberg |date=2011 |title=Cerebral amyloid angiopathy in the elderly |url=https://www.ncbi.nlm.nih.gov/books/NBK556105/ |journal=Ann Neurol |volume=70 |issue=6 |pages=871–80 |doi=10.1002/ana.22516 |pmid=22190361 |pmc=4004372 |via=National Institute of Health}}</ref> Amyloid buildup causes brittle blood vessels, which can lead to lobar intracerebral hemorrhages (ICH). In addition, [[hemosiderosis]], inflammatory [[leukoencephalopathy]], [[Alzheimer's disease]], accidental microbleeds, cognitive deficits, and transitory neurological symptoms may manifest.<ref>{{Cite journal |last1=A |first1=Charidimou |last2=Q |first2=Gang |last3=DJ |first3=Werring |date=2012 |title=Sporadic cerebral amyloid angiopathy revisited: recent insights into pathophysiology and clinical spectrum. |url=https://www.ncbi.nlm.nih.gov/books/NBK556105/ |journal=J Neurol Neurosurg Psychiatry |volume=83 |issue=2 |pages=124–37 |doi=10.1136/jnnp-2011-301308 |pmid=22056963 |via=National Institute of Health}}</ref>

==Causes==
The cause of Cerebral Amyloid Angiopathy are unknown. Sometimes it can be hereditary, however, there have been cases where it is developed in the elderly, especially in people over 55 years of age.<ref name=":0" />

High blood sugar is the primary cause of diabetic angiopathy. The [[endothelium]], a smooth layer of the cell wall, is weakened and the artery-lining cells are injured. Rough patches develop along the endothelium and may promote the accumulation of deposits known as plaque. These deposits gradually harden and become more noticeable over time, restricting [[Stenosis|(stenosing)]] the artery and impairing normal blood flow. Different organs receive insufficient oxygen-rich blood due to the bottleneck that was formed.<ref name=":1" /> 

==Symptoms==
Individuals with cerebral amyloid angiopathy typically have no symptoms. However, spontaneous lobar bleeding is the most frequent clinical sign when symptomatic. The clinical impairments are primarily determined by the site and extent of the bleeding. Larger hemorrhages may result in greater focused deficits, headaches, seizures, speaking difficulties, and muscular weakness. Smaller [[Bleeding|hemorrhages]] may produce [[Alternating hemiplegia of childhood|hemiplegia]] and diminished consciousness.<ref>{{Citation |last1=Kuhn |first1=James |title=Cerebral Amyloid Angiopathy |date=2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK556105/ |access-date=2024-10-14 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32310565 |last2=Sharman |first2=Tariq}}</ref>  
 
==Treatment==
Currently, while there is no cure for angiopathy, there are ways through which the symptoms can be managed. For example, therapies. Treatment options for situations of muscle weakness may include speech, occupational, or physical therapy. Medication can be used for potential seizures and memory loss.<ref name=":0" />

lobar intracerebral hemorrhages(ICH) linked to CAA is often recurring. Due to this high prevalence, when there isn't a clear justification for anticoagulation, doctors usually avoid [[Antiplatelet drug|antiplatelet medicines]] and [[Anticoagulant|anticoagulants]]. Notably, research has shown that people with [[atrial fibrillation]] benefit from restarting anticoagulation.<ref>{{Cite journal |last1=Biffi |first1=A. |last2=Battey |first2=T.W.K. |last3=Ayres |first3=A.M. |last4=Cortellini |first4=L. |last5=Schwab |first5=K. |last6=Gilson |first6=A.J. |last7=Rost |first7=N.S. |last8=Viswanathan |first8=A. |last9=Goldstein |first9=J.N. |last10=Greenberg |first10=S.M. |last11=Rosand |first11=J. |date=2011-11-15 |title=Warfarin-related intraventricular hemorrhage |journal=Neurology |volume=77 |issue=20 |pages=1840–1846 |doi=10.1212/WNL.0b013e3182377e12 |issn=0028-3878 |pmc=3233208 |pmid=22049204}}</ref>

Despite the fact that CAA does not appear to be primarily caused by hypertension, blood pressure reduction has also been linked to advantages in terms of mortality.[8] Blood pressure control reduced the risk of CAA-related ICH by 77%.<ref>{{Cite journal |last1=H |first1=Arima |last2=C |first2=Tzourio |last3=C |first3=Anderson |last4=M |first4=Woodward |last5=MG |first5=Bousser |last6=S |first6=MacMahon |last7=B |first7=Neal |last8=J |first8=Chalmers |date=2010 |title=Effects of perindopril-based lowering of blood pressure on intracerebral hemorrhage related to amyloid angiopathy: the PROGRESS trial. Stroke. |url=https://www.ncbi.nlm.nih.gov/books/NBK556105/ |journal=PROGRESS Collaborative Group |volume=41 |issue=W |pages=394–6 |via=National Institute of Health}}</ref> 

Finally, a small body of research has demonstrated the advantages of using [[immunosuppression]] to treat the inflammatory forms of CAA.<ref>{{Cite journal |last1=Kinnecom |first1=C. |last2=Lev |first2=M. H. |last3=Wendell |first3=L. |last4=Smith |first4=E. E. |last5=Rosand |first5=J. |last6=Frosch |first6=M. P. |last7=Greenberg |first7=S. M. |date=2007-04-24 |title=Course of cerebral amyloid angiopathy-related inflammation |url=https://pubmed.ncbi.nlm.nih.gov/17452586/ |journal=Neurology |volume=68 |issue=17 |pages=1411–1416 |doi=10.1212/01.wnl.0000260066.98681.2e |issn=1526-632X |pmid=17452586}}</ref>



==References==
{{reflist}}

{{Vascular diseases}}
[[Category:Vascular diseases]]