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Disease of peripheral vessels of legs

 
, medical expert
Last reviewed: 14.08.2021
 
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Peripheral vascular diseases are usually classified by doctors as a sign of atherosclerosis (the development of fat deposits that narrow the peripheral arteries of the foot). How to recognize this disease and what to do if it is already diagnosed?

Description of peripheral vascular disease

At the mention of the term "peripheral vessels" most people think of the heart. But their narrowing can affect other areas of the body, in particular - some types of pain in the legs. This may be an important warning sign about potentially serious circulatory problems.

When the pain in the legs occurs with physical activity and the legs stop hurting right after rest, there is a possibility that the vessels of the legs are blocked. Doctors call this state of lower limbs peripheral vascular disease.

Pain in the legs with this indisposition is serious enough to prevent a person from working, walking on the tennis field, or even crossing the street. Symptoms of peripheral vascular disease are also known as atherosclerosis of the extremities. In this disease, fibrous plaques in the vessels can narrow the large and medium arteries of the body, preventing the flow of blood.

As these plaques grow, the arteries lose elasticity, cracks and roughness appear on their smooth inner surface, this is more likely to increase the risk of "catching" blood clots that cling to the walls of the arteries. This is not the same for the arterial system of each person: in some, atherosclerosis clogs the channels that supply blood to the heart muscle and brain; in others, plaques accumulate mainly in the vessels that lead to the extremities - most often the legs.

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Causes and risk factors for peripheral vascular disease

Some degree of narrowing due to peripheral atherosclerosis occurs in 12 percent of people aged 65 to 70 and up to 20 percent in those over 75, and only a fraction of these people experience any symptoms of atherosclerosis at the onset of the disease. In others, it first passes asymptomatically.

With stenosis, or narrowing of the artery, which usually supplies blood to the legs, small vessels try to compensate for blood flow around the blood clot in the artery. This strategy ultimately fails, because these secondary blood channels simply do not have the capacity of the large artery.

Deficiency of blood flow can go unnoticed until the disease at the initial stage and do not need much movement. But if necessary, move faster and more intensively, the circulatory system can no longer supply enough oxygen, and this becomes too obvious.

Arteries are sorely lacking in oxygen, which is their fuel, muscles literally screaming in pain. Such discomfort can be perceived by a person as numbness or fatigue. On the outer level, this is called intermittent claudication (the term comes from claudicare, it is the Latin verb "to limp"). Smoking is an increased risk factor.

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Symptoms of peripheral vascular disease

A classic symptom of peripheral arterial disease is spastic pain in the legs when walking - intermittent claudication. Pain can intensify when a person goes faster or uphill. The pain usually abates when a man or woman is resting. The reason for this is ischemia in the working muscles, a kind of "foot-angina". Angina pectoris, or chest pain, is usually caused by insufficient blood supply to the heart muscle, stenocardia of the legs - by analogy.

Pain in the legs and limp is most often caused by overloading during sports exercises, but it can also be caused by other factors. Among them - the effect of cold or certain medications, for example, some beta-blockers, which narrow the blood vessels and reduce peripheral blood flow.

The position of the blockage of the arteries determines the symptoms of worsening of the blood flow in the legs. If the obstruction is relatively small in the arterial branches of the leg, shin pain may be the result. A stronger blockage of blood flow can lead to hip pain, and blockage of blood flow above the groin area (in the blood vessels of the abdominal cavity) can cause pain in the buttocks and impotence.

Severe narrowing of the arteries

When the arteries are strongly narrowed or blocked at all - pain in the legs can be felt even during rest. Either the legs may look normal, but the fingers can be pale, lose color or acquire a bluish tint (especially when the legs are in the air). They will be cold to the touch. Impulses in the legs may be weak or absent altogether.

In the most severe cases of oxygen starvation, tissues can die off. The lower part of the leg, ankles can be covered with trophic ulcers, and in the most neglected cases of gangrene can lead to the need for amputation of the fingers or legs. However, such serious complications of peripheral arterial disease are rare.

Diagnosis of peripheral vascular disease

Diagnosis is based on medical history and physical examination, as well as additional tests to determine the degree of blood flow - Doppler ultrasound, arteriography or MRA (magnetic resonance angiography).

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Treatment of peripheral vascular disease

Depending on the overall health of the patient and the degree of peripheral atherosclerosis, the treatment of peripheral vascular disease includes good foot care after a daily walking program. The available blood flow interlocks should be eliminated or reduced conservatively, or the shunting of blood around the blocked area of the arteries is applied. Smoking should be stopped immediately. This exacerbates the problems associated with blood flow.

Pentoxifylline (Trental) can be used as a treatment, this drug makes the blood less viscous, it flows more easily with the help of smaller blood vessels. Such treatment helps many patients.

Experts disagree about the benefits of small doses of aspirin. Supporters of this method say that the use of aspirin can slow the progression of arterial narrowing and possibly reduce the need for surgery, even if aspirin does not relieve pain.

Other physicians say that with peripheral vascular disease of a person who regularly takes aspirin, there may be blood clotting problems.

Depending on the site and degree of peripheral vascular disease, the operation may include arterial bypass with an arterial graft, endovascular plastic (penetration into the blood vessel), surgical operations (angioplasty or atherectomy).

What questions should I ask my doctor about peripheral vascular disease

What to do with cramps in the leg or sprain of the ligament? What kind of treatment do you recommend?

If the treatment involves pain medications, what are the side effects of the medications?

If you take drugs with aspirin, will you combine taking aspirin with other treatments?

In addition to walking, which there are special exercises for the feet?

Do you recommend surgery? What are their side effects, risks, is it possible to apply another method of treatment?

How to help your feet?

With insufficient amounts of blood reaching the legs, they become susceptible to trauma or infection, which can persist and develop into ulcers. Therefore, people with atherosclerosis of peripheral vessels should wash their feet every day, and immediately apply a moisturizing lotion or baby oil.

A very good method of prevention is to lay cushions of cotton or sheep's wool between toes if the fingers are badly bent. And from above put on the shoes in which you will walk. You should also wear comfortable, breathable shoes or shoes that protect your feet, avoid shoes made from leatherette or other synthetic materials.

Keep your feet warm in the cold season is also important. Woolen socks, like combinations of wool and cotton. Also good that the legs were healthy.

Patients with peripheral vascular disease should not wear garters, stockings, socks made from resilient materials, because they can interfere with blood flow.

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