Obliterating atherosclerosis of the main vessels( arteries) of the lower limbs is one of the most common variants of arteriosclerosis of the vessels of the human body.
He delivers patients not only physical suffering, but also threatens disability, disability and even death.
- 1 Description of the disease and its prevalence
- 2 Causes and risk factors
- 3 Classification and stages
- 4 Dangers and complications
- 5 Symptoms, diagnosis and treatment methods
- 6 Forecasts
- 7 Prevention measures
Description of the disease and its prevalence
According to medical studies, obliterating atherosclerosis of the leg vessels is about16-17% of the number of all vascular diseases. Thus the most part of patients with this illness become invalids of 1-2 groups , and to each fourth of them it is necessary to amputate the lower extremities.
This disease carries the chronic progressive nature of .The mechanism of its occurrence and development is as follows:
- For various reasons, which will be discussed below, single or multiple foci of cholesterol deposits( plaques) appear on the internal wall of the arteries.
- Gradually the plaques expand, resulting in a narrowing of the lumen of the vessel and its deformation.
- As a result of the , the artery is partially or completely occluded by - the blood flow stops, hypoxia of nearby tissues of the extremity occurs.
- In advanced cases, the tissues of the leg, deprived of food and oxygen, begin to die, which leads to gangrene.
- Atherosclerotic plaques can cause the formation of thrombi , which in turn are deadly when exposed to blood flow in the vessels of vital organs( heart, lungs, brain).
Causes and risk factors for
The cause of obliterating atherosclerosis is a disorder of fat metabolism, which leads to the formation of the so-called "harmful" cholesterol and its deposition on the walls of vessels with the subsequent formation of atherosclerotic plaques.
Physicians found that this pathology is more likely to develop in a person, the more in his life the following provoking factors:
- diabetes mellitus;
- ischemic heart disease;
- high-grade hypertension;
- autoimmune diseases;
- elevated cholesterol level in the blood;
- bleeding disorder;
- unhealthy lifestyle( smoking and excessive consumption of alcohol);
- heavy physical labor, coupled with a heavy load on the legs.
Additional risk factors for the development of obliterating atherosclerosis are:
- age - the older, the more likely the disease develops;
- sex - men are sick several times more often than women;
- hereditary predisposition to this ailment;
- is a history of leg injury with penetrating wounds.
Classification and stages
Obliterating atherosclerosis of legs may be depending on location:
- unilateral or bilateral;
- of the femoral, popliteal or iliac artery.
During the disease, several stages of are isolated, which simultaneously indicate the degree of the pathological process:
- 1 stage - initial manifestations. At this stage, the ailment is just beginning, so the patient is practically not worried about his condition: he can only notice that his foot has become pale and constantly freezes, fatigue occurs more quickly when walking.
- 2A stage - intermittent claudication. Fatigue and stiffness in the muscles of the legs increases: even when trying to pass a distance of about 200 m there are pains in the leg.
- 2B stage - restriction of motor activity. The patient can not pass 200 m without stopping and respite - severe pain and stiffness in the leg interferes.
- Stage 3 - intense pain. Pain and discomfort in the leg accompany the patient even at rest. Walking is almost impossible.
- 4 stage - trophic ulcers and gangrene. On the aching leg there are areas of necrosis, trophic ulcers are the first signs of gangrenous inflammation.
These photos show the 3rd and 4th stages of the obliterating atherosclerosis of the vessels of the lower extremities:
The third stage and its photo:
Photos of the fourth stage, the legs begin to rot, ulcers and gangrene:
Read more about the disease from this video:
Danger and complications
With obliterating atherosclerosis , the likelihood of developing:
- impotence in men incommunication with circulatory disorders in the iliac arteries;
- acute arterial obstruction of blood vessels;
- trophic ulcer and tissue necrosis;
- dry or wet gangrene;
- is a thrombosis of other vital arteries that can lead to a heart attack or stroke.
Symptoms, Diagnosis and Treatment Methods
Symptoms of obliterating atherosclerosis of the leg vessels are primarily:
- pain in the gastrocnemius muscles: first only under load, then - and at rest;
- chilliness and palpable skin cold on the affected leg;
- numbness and "goose bumps" in the aching leg;
- the so-called "intermittent claudication" - when walking suddenly begins to fall on a sick leg;
- attenuation or complete disappearance of the pulse on one of the legs;
- blanching of the skin - in the initial stages of the disease, in the future the skin on the leg becomes cyanotic, there appear long-healing wounds and abrasions;
- , the diseased leg is externally different from healthy: it can look thinner, the nails and hair on it grow slower or do not grow at all.
In clinical practice, in addition to the examination and patient complaints in the diagnosis of obliterating atherosclerosis , the following test methods are important:
- general blood and urine tests;
- blood test for cholesterol;
- ultrasound of vessels and dopplerography;
- X-ray angiography with contrast;
- rheovasography - check the blood flow in the vessels of the legs with the help of a recording electric appliance;
- magnetic resonance imaging or computed tomography is the most accurate method of investigation to date.
Practical methods for treating atherosclerosis obliterating arteries of the lower extremities:
- Medication( conservative) therapy .Used drugs to reduce cholesterol, antithrombotic and vasodilator drugs, multivitamins and antioxidants.
- Physiotherapeutic procedures: electrotherapy, magnetotherapy, laser therapy, balneotherapy, hydrogen sulphide mud applications, ozone and barotherapy.
- Surgical intervention of is indicated at stages 3 and 4 of the disease, sometimes earlier - in order to prevent future amputation of the limb. Types of minimally invasive surgical operations: balloon angioplasty, cryoplasty, stenting.
Types of open surgical operations for obliterating atherosclerosis of lower limb vessels with preservation of the lower limb: shunting, endarterectomy, sympathectomy, arterial prosthetics .In the fourth part of patients, amputation of the affected limb is necessary.
More on the diagnosis, symptoms and modern methods of treating atherosclerosis of the vessels of the lower extremities, see the video:
If obliterating atherosclerosis was detected at the initial stage, the patient will have a long and persistent conservative treatment of .Subject to compliance with all the recommendations of the attending physician, you can not be afraid of serious complications of this pathology - the forecast in this case is quite favorable.
If the pathological process has gone so far that the patient is experiencing considerable difficulty in moving and can not walk even 200 m on foot - the is faced with the question of the need for surgical intervention. Practically now minimally invasive techniques of vascular surgery give excellent results and relieve the patient from the perspective of disability.
In 25% of cases, obliterating atherosclerosis leads to loss of limb due to the amputation of .It is impossible to avoid this, if signs of gangrene appeared, the pain became unbearable and prevents a person from sleeping, conservative therapy is ineffective, and the disease progresses.
Prevention of obliterating atherosclerosis is to:
- prevent the development of disease in patients at risk( obesity, adverse heredity, smokers, etc.);
- to slow down or completely stop the progression of disease in its initial stages.
For this it is necessary:
- to fight against excess weight, obesity and hypodynamia;
- to abandon the use of nicotine and alcohol;
- treat associated diseases that provoke the development of atherosclerosis - hypertension, endocrine diseases;
- with an increased level of cholesterol to use prescribed medications statics;
- adhere to the antiatherosclerotic diet - therapeutic table number 10 with a minimum of animal fats, flour and confectionery products;
- at the first signs of atherosclerosis immediately contact a vascular surgeon or phlebologist and immediately begin treatment if necessary;
- allowed the use of some folk remedies.
In time detected signs of ailment, urgent medical attention and scrupulous treatment are practically the guarantor of life without disability in case of obliterating atherosclerosis.