Dr. Jean-Michel Barbaste
Graduate of Lille Medical School: 1985.
Angiologist since 1985.
Consultant at Saint Philibert Hospital (student training in vascular ultrasonology) from 1985 to 1991.
Consultant at the" Private French Hospital" in Hanoi (Vietnam) from 2000 to 2006.
Currently in Private Practice in France and UK.
Vascular Medicine is the clinical discipline which intervenes in prevention, diagnosis, treatment and follow up for patients who are suffering from vascular complaints: arterial, venous, lymphatic or micro vascular diseases.
Why do I have to check my arteries?
Because your arteries are may be damaged, without your knowing, with atheroma or aneurysm.
Atheroma: Is a degeneration of the walls of the arteries due to the formation of fatty plaques and scar tissue. The arterial diameter is reduced: this is the stenosis which limits blood circulation and predisposes to clot. A diet rich in animal fats (cholesterol) and refined sugar, cigarette smoking, obesity and inactivity are the principal causes. But heredity is an important factor of risk also.
A few definitions
Thrombosis: Is when the artery is completely blocked with atheroma or blood clot. There is ischemia (Lack of blood flow and death of tissues) Embolism: Sometimes a fragment of plaque comes off: it is an embolism. It may be stuck further along an artery with smaller diameter. Sometimes you may feel pains in your calves on exercise causing intermittent claudicating or at rest (Lower Limbs Arteriopathy). Sometimes you feel neurological troubles (you suffer from dizzy spells, disturbed vision… But often it is symptomless. That is why it is important for you to check your arterial system before these complications occur: muscular ischaemia with risk of gangrene, angina pectoris, heart attack, stroke)
Aneurysm:A balloon-like swelling in the wall of an artery. This may be due to degenerative disease or it may be the result of a congenital deficiency in the muscular wall. The aneurysms may occur anywhere but often they are in the abdominal aorta. These aneurysms may rupture causing internal bleeding or fatal hemorrhage. Detected in time they can be operated on with good results.
Are these lesions frequent?
Yes, cardiovascular diseases are the mayor cause of mortality in Europe.
Lower Limbs Arteriopathy: Affects between 10 and 20% of 50 year old men or more. In this case, there are also coronary lesions in 50% of cases. Without treatment, patients suffering from Lower Limbs Arteriopathy have a 30% 5 year mortality rate.
Stroke: This is the third cause of mortality. It causes one out of two deaths or severe after effects. 90% of cases are caused by a thrombosis.
Ulcered Carotid Plaque: Possible Developments of a plaque of atheroma in a Carotid Artery
Abdominal Aorta Aneurysm: Exists among 5% of men. It is usually asymptomatic but if it ruptures it can have a 50% mortality rate. So it is with systematic screening that diagnosis is done and patients are saved.
When to see a doctor?
You have symptoms suggestive of Lower Limbs stenosis:
Cramps in calves after several hundred of metres walking
Pain in your calves at the end of the night
Purple and cold feet
You have symptoms suggestive of cerebral vascular disorders: Disturbed vision, double vision
Dizziness, loss of balance
Sensory or motor disorders
I have factors of vascular risk: Smoking even if I gave up many years ago
Hypercholesterolemia or hypertriglyceridemia
Obesity or excess weight
Vascular diseases in your family