Vascularopatias

Vascularopatias, or vascularopathies, are a group of disorders characterized by structural or functional abnormalities of the blood vessel walls and the vascular network. They can affect arteries, veins, capillaries and lymphatic vessels and may cause ischemia, edema, hemorrhage, or organ dysfunction.

Etiology is diverse, including genetic mutations, autoimmune processes, infection, metabolic disorders, and environmental factors. They can present as primary vascular diseases or as manifestations of systemic conditions.

Classification commonly divides vascularopathies into primary diseases of the vessels (such as vasculitides, congenital vascular malformations, and some microangiopathies) and secondary vascularopathy associated with systemic illnesses (for example diabetes-related microangiopathy, hypertension-related vascular remodeling, inflammatory or infectious vasculitis, and coagulopathies).

Common subtypes include arterial diseases such as atherosclerosis and aneurysm formation; venous disorders such as deep venous thrombosis and chronic venous insufficiency; microangiopathies like thrombotic microangiopathy and diabetic microangiopathy; vasculitides; and congenital malformations such as arteriovenous malformations.

Clinical features depend on the vessel territory involved and may include claudication, stroke, organ ischemia, edema, ulcers, or bleeding. Diagnosis relies on clinical assessment supported by imaging and laboratory studies. Noninvasive vascular imaging (doppler ultrasound, CT angiography, MR angiography) is central, while biopsy or histology is used in selected cases to distinguish vasculitis or inflammatory vascular disease. Laboratory testing may include inflammatory markers, autoantibodies, and coagulation studies.

Management is tailored to the subtype and may include risk-factor modification, antiplatelet or anticoagulant therapy, immunosuppression for inflammatory vasculitides, endovascular or surgical intervention for aneurysms or occlusive lesions, and treatment of underlying systemic disease.

Prognosis varies widely; some conditions remain stable with treatment, while others progress and cause significant morbidity. Ongoing research aims to clarify pathophysiology and develop targeted therapies.