Peripheral Artery Disease

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About a disease

Description

Atherosclerosis of the lower extremities is a chronic vascular disease, which is based on violations of lipid metabolism, leading to the formation of atherosclerotic plaques, thickening of the walls of the arteries and reducing the vascular lumen. As a result, ischemia develops – insufficient oxygen supply to the cells and tissues of the lower extremities.

Most often, the popliteal, femoral and tibial arteries are involved in the pathological process.

Atherosclerosis of the arteries of the lower extremities is in the first place among the diseases of the peripheral arteries of atherosclerotic origin.

Symptoms

With atherosclerosis, the patient can feel and observe the following:

– muscle pain in the legs

– cramps

– tingling, numbness in the affected area;

– sores on the skin;

– livid color of the fingers;

– cooling of the skin of the leg;

Diagnostics

There is a standard diagnostic program for this disease:

– Ultrasound of lower extremity vessels ( duplex and Doppler scanning);

– Coagulogram (determination of the blood clotting system);

– Determination of cholesterol and LDL levels in the blood;

– Arteriography of the legs;

– Establishment of pulsation in the peripheral arteries;

– Mr -, MSCT-angiography.

– MRI and CT scans with contrast and reovasography can be performed as prescribed by a doctor.

Treatment

Percutaneous transluminal angioplasty of the lower extremity vessels is a minimally invasive procedure that expands the arteries of the lower extremities. The procedure consists of inserting a hollow catheter equipped with a balloon into the vascular bed and an artery affected by atherosclerosis. The catheter advances under x-ray control. When the catheter reaches the place of narrowing of the artery, the balloon inflates. Due to the pressure of the balloon, partial destruction of atherosclerotic plaques occurs, increasing the lumen of the vessel and restoring blood flow through it. After the test images are taken, stenting is performed for indications – a stent is inserted (a compressed spring, which is made using a special alloy). The stent is straightened in the artery, resulting in the expansion of the vessel diameter and normalization of blood supply to the lower extremities.

Thrombendarterectomy is an open surgical intervention to remove thrombotic masses from the arteries affected by atherosclerosis, which provides normalization of blood supply to the lower extremities.

Surgical intervention to restore blood supply to the lower extremities by shunting is to install a shunt bypassing the clogged segment of the artery. The blocked area or lumen of the vessel remains closed even after surgery. Bypass surgery can be performed from your own tissues (often, a large saphenous vein) or with a vascular prosthesis.

If trophic ulcers are poorly treated conservatively, they are operated on, removal of necrosis (affected tissues) is performed and the patient’s own skin is covered – transplantation of their own skin.

Amputation – is prescribed in severe cases when gangrene occurs, after which prosthesis installation technique is performed.

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