angiopathy

Angiopathy is a general term for disease of the blood vessels in which structural or functional abnormalities affect arteries, veins, or capillaries. It is used as an umbrella for conditions that alter vessel walls or perfusion, and it is often specified by the type of vessel involved (arteriopathy, venopathy, or microangiopathy) or by the affected organ or underlying cause (for example, diabetic angiopathy or cerebral angiopathy).

Pathophysiology varies with the size and type of vessels involved. Small-vessel angiopathy, or microangiopathy, often involves endothelial dysfunction and basement-membrane thickening that narrow capillaries and arterioles. Large-vessel angiopathy can cause stenosis, occlusion, aneurysm formation, or abnormal collateralization. The resulting changes can impair blood flow, cause tissue ischemia, and increase the risk of hemorrhage in certain contexts.

Causes are diverse and include chronic diseases (notably diabetes mellitus and hypertension), atherosclerotic disease, inflammatory or vasculitic disorders, infectious vasculopathies, radiation-induced injury, and hereditary vascular disorders. Angiopathy may be part of systemic conditions or localized to a specific organ system, such as retinal angiopathy in diabetes or cerebral angiopathy in certain degenerative or inflammatory states.

Diagnosis relies on clinical assessment combined with imaging and laboratory studies. Imaging options include ultrasound, CT angiography, MR angiography, and conventional angiography to visualize vessel anatomy and blood flow. Laboratory tests help identify underlying systemic diseases, while tissue biopsy may be used in selected cases.

Management targets the underlying cause and may include metabolic control (as in diabetes), blood pressure management, antiplatelet or anticoagulant therapy, immunosuppressive treatment for vasculitis, and, when feasible, revascularization procedures. Prognosis depends on the extent of vessel involvement and the success of addressing the underlying condition.