Oblique atherosclerosis of the leg vessels is a pathology in which atheromatous plaques form on the walls of the arteries of the lower extremities. As the disease progresses, atherosclerotic deposits increase in size, which leads to obstruction (blockage) of blood vessels and impaired blood flow in the legs.
In advanced cases of the disease, the blood supply to one or both legs completely stops, which requires radical measures of treatment.
Atherosclerosis of the leg vessels is considered to be a fairly common, but very serious pathology among other diseases of the vascular bed of the lower extremities:
- The largest percentage (5–7) of patients is detected among people over 60,
- In the age category 50 - 60 years, pathology is 2 - 3%,
- In forty-fifty years old - 1%.
- It is noted that this disease occurs 8 times more often in men than in women.
Causes and mechanism of development
Three main etiological factors of leg atherosclerosis were identified:
- high blood cholesterol levels (increased total cholesterol, lipoproteins), which has been observed for many years,
- genetic predisposition - the disease occurred in the family,
- impaired metabolism, mainly fat.
The causes of the disease include:
- smoking causes a spasm of the arteries that disrupts blood flow,
- addiction to alcohol - violates the metabolism, in particular fat, in the liver,
- excessive consumption of animal fats,
- hormonal disorders: diabetes mellitus (provokes the occurrence of atherosclerosis of the leg vessels even in adolescence) imbalance of sex hormones, hypothyroidism,
- arterial hypertension ,
- regular stress (contributes to the release of adrenaline, which spasms the arteries),
- age (the risk of developing the disease increases after 40),
- belonging to the Negroid race,
- regular hypothermia
- arteritis of the lower extremities,
The pathogenesis of the disease consists of several stages:
At this stage of lipoidosis, fats are deposited on the vascular walls in the form of spots and streaks, which somewhat slow down the blood flow and lead to microdamages of the blood vessels.
It is called liposclerosis. In the fatty deposits begins to grow young connective tissue. These atheromatous plaques consist of fats and connective tissue fibers. They are still liquid and can dissolve with adequate therapy. The walls of blood vessels change: at the location of the plaque, the wall becomes brittle, cracks, with the further formation of micro-ulcers. This leads to the formation of blood clots.
The stage of atherocalcinosis, in which the plaques are compacted, calcium salts begin to deposit in them. With a stable and gradual growth of plaques, the lumen of the arteries is deformed, gradually narrowing. These changes cause increasing chronic disruption of blood supply to the leg. In the event of a blockage of a vessel with a thrombus or a detached plaque, necrosis of the lower extremity (gangrene) develops.
Leg pain and other sensations
The pain is usually localized in the calf muscles. Such an arrangement of pain is due to the distribution of physical activity, the maximum part of which falls on the legs. In addition, the gastrocnemius muscles have a minimum number of arteries, which, if any vessel is obstructed, provokes the occurrence of pain in them.
At the early stage of the development of pathology, pain occurs only in the case of a significant load (running or long walking). Also, patients are worried about other sensations: chilliness, cooling or numbness of the feet, night cramps. In advanced cases, patients complain of severe pain in the legs, which spread to the feet. Such pains are permanent, occur at rest, do not stop with analgesics.
The stronger the arteries are, the more intense the pain and the more often it occurs. Patients are forced to stop while walking, wait for the pain to subside. As the disease progresses and progresses, the pain begins to bother at rest, especially when lying down. Such night pains interfere with sleep and in order to lower their patient is forced to lie with their legs dangling from the bed.
This clinical sign serves as an obligatory criterion for the disease. According to it, you can judge the degree of violation of the functionality of the leg muscles. Patients complain of significant weakness in the legs, which is accompanied by pain when walking (distances vary from 1000 meters to 20 meters). After overcoming a certain distance, the patient needs to stop and take a short rest. After that, the person continues to walk again until a new attack of weakness appears. This phenomenon is called intermittent claudication.
Appear as a result of a violation of the structure of the muscles of the skin of the legs, due to impaired blood circulation in them.
- The skin of the feet becomes pale, cold to the touch.
- Begin to fall out hair.
- The calf and femoral muscles become thinner, losing volume and mass (muscle wasting).
- On the skin, in the subcutaneous tissue, in the muscle fascia ulcerations occur, which are transformed into long-term non-healing trophic ulcers.
- Due to the violation of trophism (nutrition) and oxygen starvation of tissues, gangrene of the toes can develop.
- There is a fungal disease of the toes and nails.
- The feeling of "alien legs" - uncontrollability of movements, loss of control in the knees, ankle.
- Perhaps the appearance of cyanosis of the skin, and then necrosis of the toes, followed by the feet, legs, thighs.
Stages of the disease
The disease proceeds in 4 stages:
- the first - pain, weakness of the lower extremities are observed with significant physical exertion,
- the second - pain syndrome occurs when overcoming a distance of 200 - 1000 meters,
- the third - the pain starts to bother after 50 - 200 meters of walking,
- the fourth is the impossibility to overcome short distances (less than 50 meters), gangrene of the fingers or the feet takes place.
It is difficult to diagnose pathology at an early stage. The patient’s initial referral may be to a doctor of a different specialty (surgeon or vascular surgeon, neurologist, general practitioner, angiologist). The doctor carefully collects the patient's complaints, examines the history of life (identifying risk factors) and the disease, conducts a physical examination. Physical examination reveals:
- weak pulse in the vessels of the legs or lack thereof,
- artery auscultation - determination of systolic murmur,
- low blood pressure in the leg vessels
- pallor and cyanosis of the skin of the feet, lower legs, blue fingers under the nails.
How to check the vessels of the legs for atherosclerosis yourself? For this you need to conduct a simple test. The patient must lie down on a hard surface and raise his legs, without bending his knees, at an angle of 45 degrees. If the exercise causes blanching of the feet and the appearance of weakness in the legs, this indicates the presence of atherosclerosis of the vessels of the lower extremities. The more neglected the disease, the faster the symptoms listed appear.
If you suspect a pathology of blood vessels, the doctor will prescribe the following tests:
- complete blood count (excluding anemia, inflammation),
- biochemical blood test (determination of liver enzymes, cholesterol, bilirubin, homocysteine, triglycerides, total protein, LDL, HDL, fatty acids, glucose - detection of metabolic disorders),
- coagulogram (platelets, prothrombin, prothrombin index, clotting time, bleeding time - determining the tendency to thrombosis),
- urinalysis (density, sediment, uniform elements - assessment of the work of the kidneys).
Laboratory research and analysis of analyzes helps to calculate the coefficient of atherogenicity, on the basis of which judged on the neglect of the disease.
Treatment of atherosclerosis of the leg vessels depends on the data obtained from instrumental methods of investigation. Apply to:
- duplex vascular ultrasound - arteries are displayed in red, veins in blue,
- angiography - the introduction of contrast into the bloodstream and obtaining X-rays,
- Mr and CT angiography,
How to treat atherosclerosis of the legs? Therapeutic tactics depend on the severity of clinical manifestations, stage of the disease, the presence of chronic somatic pathology, complications.
It is necessary to refuse or limit consumption of fats of an animal origin. Foods containing large amounts of cholesterol include high-fat dairy products, eggs, lard, fatty meats, poultry, offal, caviar. It is not recommended to use pastry, sweet pastry, mayonnaise, margarine, butter, sausages. In the diet, you must enter the fresh and cooked vegetables, fruits, berries. Consumption of cereals, nuts, seeds, sea fish of fat varieties (herring, mackerel, salmon), and vegetable oils is also recommended.
Rejection of bad habits
A smoking patient needs to give up the habit or at least reduce the number of cigarettes smoked, otherwise even effective medicines will not slow down the further progression of the disease. Alcohol affects the work of the liver, so its further use will only aggravate the process.
It is important to abandon cramped, crushing shoes made from non-natural materials, as well as heeled shoes. Shoes should be loose, comfortable. It is necessary to avoid minor injuries of the legs, timely treat cuts, cracks, calluses, wash the feet every evening, avoid hypothermia of the feet.
In the medical treatment of pathology used drugs of certain groups:
- Agents that reduce platelet aggregation (sticking): aspirin, cardiomagnyl, atercard, colloidal solutions for intravenous infusions: reopoliglyukin, dextran 40, polyglukin,
- drugs that improve blood rheology: pentoxifylline, chimes, tirofiban,
- agents that improve the trophism of tissues with a regenerating effect: Cilostazol, zincteral, nicotinic acid,
- antispasmodics and vasodilators: Drotaverinum, papaverine, vazonit, agapurin,
- vitamins: group B, ascorbic acid, vitamin PP - strengthen the vascular wall, prevent the deposition of fat and calcium in the vessels,
- anticoagulants (in case of thromboembolic complications): heparin, warfarin,
- antibacterial ointment (with the formation of trophic ulcers): levomekol, oflokain,
- fibrates (reduce the content of lipoproteins, cholesterol): gemfibrozil, clofibrate, fenofibrate,
- thrombolytic (in the formation of blood clots): streptokinase, urokinase,
- Statins (lower cholesterol synthesis): atoris, pravastatin, simvastatin,
- drugs that bind and remove bile acids from the intestinal tube: cholesteramine, colestipol.
Also prescribed courses of physiotherapy: electrophoresis with drugs, hyperbaric oxygenation, magnetic therapy, darsonvalization, UHF. Balneotherapy has a positive effect: taking conifers, radon, pearl, hydrosulphuric baths, ozone therapy.
In half of the cases of atherosclerosis of the leg vessels, surgical treatment is carried out. Operational methods include:
- endarterectomy - excision of the artery with atherosclerotic deposits,
- shunting - a shunt (prosthesis) is installed in place of the affected area of the artery,
- lumbar sympathectomy - excision of the ganglion, which cause spasms of the arteries,
- balloon angioplasty - a balloon is introduced into the artery, which expands its lumen,
- stenting - a tubular strut is installed in the affected artery, preventing narrowing of the lumen.
- leg amputation - performed in the case of gangrene.
Treatment of traditional methods of the disease can be carried out only with the permission of a doctor in parallel with medical therapy. It is important to remember that it is impossible to get rid of atherosclerosis, all medical measures only reduce the rate of disease progression, prevent the development of complications (gangrene, trophic ulcers).
- propolis tincture - normalizes protein and lipid metabolism,
- hawthorn tincture with propolis tincture - dilates blood vessels, restores fat metabolism,
- Thyme infusion - relieves spasms, has anti-inflammatory and soothing properties,
- garlic tincture - dilates blood vessels, prevents the formation of atheromatous plaques,
- parsley tea - perfectly “cleans” the vessels (dissolves plaques),
- decoction of the roots of horseradish - prevents the formation of deposits on the walls of the arteries,
- rosehip tincture - prevents plaque formation, dilates blood vessels.
Causes of atherosclerosis of the leg vessels
Atherosclerosis occurs when cholesterol plaques accumulate on the walls of blood vessels, preventing normal blood supply to tissues and organs. Over time, plaques can turn into ulcers or completely block the vessel, which will lead to the death of this part of the vein. The appearance of cholesterol plaques contributes to unhealthy diet, bad habits, sedentary lifestyle. The most provocative factor is smoking, since in the case of smokers, the walls of blood vessels are rapidly thinning. See in the video how to recognize atherosclerosis in time:
Symptoms and signs of atherosclerosis obliterans
For a long time, obliterating atherosclerosis has no symptoms. Often the first symptom is thrombosis, but the lesion of the leg arteries occurs gradually. Initial manifestations of the disease:
- numbness of the feet,
- calf pain,
- burning skin of the feet,
- sensitivity to cold.
With the development of the disease due to problems with the blood supply to the limb, the lower leg can lose weight, hair on the leg often falls out, and nail plates are stratified. Ulcers and necrosis appear on the feet as a result of atherosclerosis obliterans. If the treatment is not carried out, then the necrosis of the lower limbs, gangrene may develop. At the first damage to the leg, pain in the legs, darkening of the skin on the foot or fingers, you should immediately consult a doctor for examination for the presence of atherosclerosis of the lower extremities.
The degree of atherosclerosis of the lower extremities
The classification of leg atherosclerosis is based on signs of arterial insufficiency and localization of the lesion. According to the level of damage to the arteries, there is an overlap of 3 levels:
- Upper - femoral, iliac arteries and aorta.
- Middle - arteries of the leg and popliteal.
- Low - one artery of the foot and lower leg.
How and what to treat atherosclerosis of the legs
Treatment of atherosclerosis obliterans of the lower extremities occurs individually. Doctors prescribe drugs, depending on the stage of the disease. The main requirements for drug treatment - is getting rid of alcohol intake, smoking, changing diet, physical therapy, aimed at improving the stability of the lower extremities to stress.
With the conservative drug treatment of atherosclerosis of the lower extremities, there are several areas:
- Anticoagulant therapy, in which drugs that prevent blood from clotting are prescribed (this happens when the blood flow rate decreases).
- Drugs that reduce platelet aggregation (sticking). If the vessel is narrowed, the blood flow may stop, leading to gangrene.
- Statins are drugs that lower cholesterol levels in a patient’s blood. This reduces the risk of complications of the disease.
In the early stages of the disease, a therapeutic massage with special ointments that improve the blood supply to the arteries has proven itself well. The procedure is performed not only by specialists, but also by the patient himself with the help of “Troxevasin” cream or other ointment prescribed by the attending physician. Excellent predictions gives a combination of massage with physiotherapy. The same procedures are suitable for the prevention of the disease.
Based on the history of the disease, the phlebologist may prescribe special exercise for the lower extremities. Therapeutic exercises aimed at improving the blood supply and strengthening the muscles of the legs. The assigned exercises are carried out in a measured-quiet pace, and their basis is swinging movements with the legs, which strengthen the large and medium muscle groups. In the first stages of treatment, the loads must be moderate, so that weak vessels will not receive microtraumas.
Treatment of folk remedies
Leg atherosclerosis is successfully treated with folk remedies. This is homeopathy, cleaning vessels with herbs, the use of tinctures, which have an analgesic, anti-inflammatory, anti-sclerotic effect on the lower extremities. Here are some effective folk recipes that help with atherosclerosis obliterans:
- Take in equal proportions the hips, hawthorn, half the flowers of elderberry, immortelle, initial letter medicinal. Mix all ingredients thoroughly. Pour 2 tbsp. spoon half a liter of boiling water, soak for 30 minutes, filter.It is necessary to use three times a day on 65 ml within 1 month. Then take a break of 10 days, and continue to drink the infusion for six months.
- Use in small doses of royal jelly. In the morning and in the evening before meals, take the drug on the tip of the knife and take it for a month. This will improve cholesterol metabolism.
- Mix alcoholic propolis tincture with vodka infusion of hawthorn in equal shares. Drink 3 times a day, 30 drops before meals for a month.
When running atherosclerosis of the lower extremities, doctors resort to surgery. There are several types of surgery:
- Shunting, when the blood flow is restored artificially by redirecting the movement of blood through a shunt.
- Prosthetics of the dead part of the artery.
- Thrombendarterectomy when cholesterol plaques are removed from the affected vessel.
- Amputation of the affected limb during the advanced stage of the disease.
Methods for the diagnosis of atherosclerosis
The doctor can diagnose atherosclerosis of the legs during external examination, when there is severe alopecia (hair loss), thick skin, brittle nails, skin color is changed, there are trophic disorders in the affected area. Also, during palpation, the doctor draws attention to the temperature of the patient's foot, because atherosclerosis is often temperature asymmetry.
To clarify the diagnosis using modern equipment: conduct duplex scanning of blood vessels, dopplerography - a non-invasive method based on the use of ultrasonic waves. In addition, the doctor may prescribe a blood test for sugar, biochemistry, fluoroscopy with the introduction of a contrast agent, MRI. In modern conditions, accurate diagnosis of atherosclerosis of the lower extremities is possible at the earliest stages of the disease.
What is hidden under this disease?
Under atherosclerosis of the legs means a disease in which a number of changes occur - a violation of the passage of blood through the peripheral vessels, the emergence of tissue trophism, etc. Most often, atherosclerosis affects large arteries of the abdominal and thoracic cavities. This is what leads to pathological changes in the popliteal, tibial and femoral arteries, the lumen in which decreases by more than 50-55%.
On the development of the disease may take more than ten years, during which she will sit quietly inside.
Stages of atherosclerosis
Experts identify several stages of development of the pathology of the blood vessels of the legs. The first - preclinical - is accompanied by a pronounced violation of lipid metabolism (lipoidosis). There are pains in the lower limbs, but they occur only after walking long distances and heavy physical exertion.
Normal and susceptible vessels
At the second stage, the first signs of atherosclerosis begin to make themselves felt - the legs hurt after passing 250-1000 m. The third period (critical ischemia) is characterized by pronounced symptoms of the disease. Pain syndrome appears after 50 m on foot. Well, at the last (fourth) stage, the skin of the legs is affected by trophic ulcers, necrosis (blackened skin) and gangrene, and severe discomfort in the legs occurs even in a calm state, including at night.
Important. If the atherosclerosis of the lower extremities does not start the treatment even at this stage, the case can end with gangrene with amputation of the legs.
The factors provoking the development of this disease can be very different. We managed to put together the main reasons:
- Smoking is the main cause of atherosclerosis. The nicotine contained in tobacco leads to spasms of arteries and prevents blood from passing through the vessels. This is a direct path to thrombophlebitis and atherosclerosis,
- Excess weight,
- Frequent eating foods rich in animal fats, and raising cholesterol,
- Health problems - diabetes, reduced production of hormones of sex hormones and thyroid gland, arterial hypertension and others,
- Genetic predisposition
- Chronic stress
- High blood pressure.
- Gender affiliation - often men with atherosclerosis of the legs,
- Reduced physical activity
- Large psycho-emotional stress
As we have said, atherosclerosis of the vessels of the lower extremities does not manifest itself for a long time, and then immediately a number of serious problems appear. Is there really not a single sign that would make it possible to recognize an incipient disease in time? Of course, there is. All of them are before you:
- Numbness of feet
- Intermittent claudication
- Rarely - embolism or acute thrombosis,
- Constant chilliness and feeling of internal cold,
- Cyanosis and paleness of the skin,
- Cramps - especially often tormented at night,
- Pain sensations - from weak to very strong,
- No ripple on the ankle, in the popliteal fossa and on the thigh,
- Trophic phenomena that manifest themselves by exfoliation of the nails and the appearance of ulcers on the toes and heels, as well as hair loss on the legs,
- Pains in the limbs, worse during walking,
- Cyanosis (lupus) of the skin.
How to diagnose
Timely and correct diagnosis in atherosclerosis of the vessels of the lower extremities plays an important role, because with its help you can learn about the causes of the disease and prescribe the correct treatment. At the hospital, you should definitely have the following consultations and procedures:
- Mr angiography
- Pressure measurement with ankle brachial index calculation,
- Peripheral arteriography,
- Duplex scanning (USDG) of peripheral arteries,
- Pulsation of limb arteries,
- Consultation of a vascular surgeon.
Also, doctors note the presence or absence of trophic disorders on the legs, establish the vascular permeability using DS and USDG, and listen to the systolic murmur over the stenotic arteries.
It would not be superfluous to conduct another small test. The patient needs to raise his legs in the prone position by 45 degrees. Knees at the same time can not bend. During the procedure, the rate of appearance of pallor on the soles of the feet and general fatigue of the legs is noted.
The treatment of this severe and dangerous disease depends on the severity and complexity of its symptoms. It can be both folk and traditional. We discuss all the details of each of them.
If you want to achieve positive changes in the fight against atherosclerosis of the leg vessels, get ready for strict implementation of the recommendations of experts:
- Follow a low cholesterol diet. You absolutely cannot eat lard, pates, margarine, butter, fatty meats, sausages, dairy products with a high percentage of fat, offal, french fries, alcohol, flour baking, mayonnaise,
- Adjust your weight
- Give up smoking and alcohol,
- Go to comfortable and spacious shoes,
- Be very careful when cutting nails,
- Do not forget to carefully handle all minor injuries of the legs and feet,
- Avoid hypothermia
- Use dosed exercise - walk at a moderate pace for at least half an hour a day, swim, exercise on the exercise bike,
- Cure concomitant diseases - hypertension, diabetes, etc.
Drug treatment approach
Treatment of atherosclerosis of the lower extremities includes a range of drugs and procedures. Only a qualified doctor can prescribe them, so be sure to visit the hospital.
What can cure this disease?
- Antiplatelet drugs (for example, Aspirin and Reopolyglyukin) - they prevent the appearance of blood clots and serve as the best prevention of heart attacks and strokes,
- Drugs that increase the physical activity of the patient. Thanks to Pentoxifylline and Cilostazol, walking is practically painless, and the general blood flow in the lower limbs is much better,
- Drugs with antiplatelet effect - they have a positive effect on the circulatory system and reduce blood cholesterol levels,
- Anticoagulants (Warfarin, Heparin) - do not allow blood to clot in the vessels, prevent the development of blood clots,
- Antispasmodics (Drotaverine) - relieve spasms and relieve pain,
- Ointment with antibiotics (Oflokain, Delaskin, Levomekol, Dimexide) - are used in the presence of trophic ulcers,
- Drugs that improve tissue nutrition (Zincteral),
- Vasodilators (Vazonit, Agapurin, Vazaprostan, Pentoxifylline, Pentillin, Trenal),
- Physiotherapy procedures - darsonvalization, electrophoresis with novocaine, hyperbaric oxygenation.
Surgery - the last measure in the treatment of atherosclerosis of the lower extremities. As a rule, surgery is prescribed for pronounced ischemia and the occurrence of very strong complications.
In this case we will discuss the following procedures:
- Shunting - creating an additional path for blood flow around the site of narrowing of the artery,
- Balloon angioplasty - the introduction into the cavity of a vessel of a balloon that expands the arterial lumen,
- Artery stenting - a tubular spacer is placed in the injured vessel that keeps the diameter of the artery at the right level,
- Endarterectomy - removal of the affected area of the vessel along with atherosclerotic plaque,
- Autodermoplastika - used to treat trophic ulcers that are poorly amenable to local therapy,
- Prosthetics - replacement by an autovenous or synthetic vessel of the affected part of the artery,
- Amputation of the necrotized department of the leg with the subsequent installation of the prosthesis.
Recipe number 1 - tincture
- Horse chestnut (fruit) - 20 g,
- Common hops - 45 g,
- Safflower-shaped bighead - 35 g,
- Water - at the rate of 200 g of liquid per 2 g of mixture.
- Combine herbal mixture.
- Fill it with boiling water only.
- Insist for three hours.
- We take a day for ½ cup.
Recipe number 2 - decoction
- Chamomile (flowers) - 1 tsp,
- Rezeda - 1 tsp,
- Plantain - 1 tsp,
- St. John's Wort - 1 tsp,
- Water - 200 ml
- Sage - 1 tsp.
If desired, the composition can be slightly changed:
- Sage - 1 tsp,
- Plantain - 1 tsp,
- St. John's Wort - 1 tsp,
- Turn - 1 tsp,
- Chamomile (flowers) - 1 tsp,
- Water - 200 ml.
- We connect all the components.
- Fill the composition (1 tbsp. Spoon) with boiling water.
- Insist about a day in a darkened closet.
- We use for applications for legs in the morning and before bedtime. Feet should be thoroughly washed before the procedure.
In the early stages of atherosclerosis of the lower extremities, a condition known as ischemia occurs. It is characterized by sensations. heaviness when walking, fatigue, local lowering of temperature in the distal affected limb.
The next stage of the disease is known as obliterating endarteritis. The characteristic symptoms of endarteritis are steady. skin blanching and intermittent claudication. In the absence of timely treatment, this pathology can lead to the development of gangrene and loss of limbs.
Atherosclerotic changes in blood vessels of varying severity are found in most people of middle and old age, however, the disease is asymptomatic at early stages of development. Pain during walking occurs later, with a significant narrowing of the lumen of the blood vessels, and indicate severe arterial insufficiency.
When to go to the doctor?
If a person is over forty years old, guards should any unexpected sensations in the foot area: stiffness, heaviness, acute sensitivity to cold, chilliness - especially if they are combined with fatigue and muscle pain. The troubles, at first glance insignificant, are in fact a threatening warning from the side of the vessels about the presence of a pathological process.
The clinical picture of vascular pathologies in the early stages of development resembles the manifestations of other diseases not directly related to impaired blood flow. Therefore, the first symptoms of suspected atherosclerosis of the vessels (veins and arteries) of the lower extremities - reason to visit a therapistwho will refer the patient to a specialist with the appropriate profile for treatment.
The pain that occurs while walking is a direct indication that you cannot postpone a visit to a phlebologist any longer. Painful sensations, changes in local temperature and skin color indicate that the pathological changes have gone far enough and are a serious threat, even a threat to life.
Very terrible phenomena - difficult healing of scratches, small wounds, slower nail growth, hair loss on the legs. If one or several symptoms are detected, you should immediately contact an endocrinologist (to rule out diabetes mellitus) or a vascular surgeon immediately.
Diet for atherosclerosis of the cerebral vessels is also suitable for patients with the form of the disease in the lower extremities. Learn more about her.
What drugs are used in atherosclerosis of the cerebral vessels? All of them are listed here.
What should I do to recover?
Each specific case of atherosclerosis requires an individual approach. In the development of treatment tactics, the presence of comorbidities, the severity of the patient’s condition, the extent of vascular lesion, and some others are taken into account. Treatment of atherosclerosis can be:
Endovascular treatment is minimally invasive alternative to surgery and is used in the later stages of atherosclerosis, when conservative methods are not sufficiently effective. A device is inserted into the affected area of the artery to prevent further narrowing of the vessel lumen.
Endovascular treatment methods include balloon dilatation, stenting and angioplasty. Procedures are performed in an X-ray surgery, after which a pressure bandage is applied to the patient and bed rest is prescribed for 12-18 hours.
When detecting long areas of blockage, surgical treatment is indicated to the patient. The most common methods of surgical treatment are:
- Prosthetics a corked area
- Thrombendarterectomy - removal of cholesterol plaque,
- Shunting - installation of an artificial vessel to bypass the clogged area of the artery. Less commonly, fragments of the patient's saphenous veins are used as shunts.
Surgery can be combined with endovascular and other types of operations depending on the condition of the patient.
In severe gangrene and extensive necrosis, the amputation of the affected limb is performed.as this is the only way to save a patient’s life.
Recipe number 3 - rubbing
- Olive oil - 1 tbsp. spoon,
- Sea buckthorn oil - 1 tbsp. spoon.
- Mix both oils.
- We rub the mixture into the affected skin like a cream.
- We use for three weeks.
- Dill seeds (crushed) - 1 tbsp. spoon,
- Boiling water - 200 ml.
- Fill the dill only with boiled water.
- We give the time to insist.
- We drink four teaspoons four times a day.
- Root elecampane (dry) - 20 g,
- Propolis tincture (20%) - 100 ml,
- Alcohol - 100 ml.
- We grind the root of the elecampane and pour it into a bottle made of dark glass.
- Insist 20 days in a darkened closet.
- Add propolis tincture.
- Taken 3 times a day for 25-30 drops.
- Rowan Bark - 400 g,
- Water - 1 l.
- Fill the mountain ash bark with 1 liter of boiled water.
- Cook for 2 hours on a quiet fire.
- Give cool and filter through gauze, folded in several layers.
- We drink before meals.
Atherosclerosis of the leg vessels is a serious and very dangerous disease that needs urgent and qualified measures. Only in this case can we hope, if not for an absolute recovery, then at least for a significant improvement in health.
Manifestations of the disease
Atherosclerosis is accompanied by sufficiently developed symptoms. Most patients complain of pain after prolonged walking or physical exertion. In some cases, the patient’s condition is so severe that he begins to limp. After the patient has a rest, he has pain in the legs.
In some patients with the appearance of atherosclerosis, a feeling of numbness in the legs appears. Also, patients complain of tingling and weakness in the legs while walking. After a prolonged load, painful sensations of pain appear in the legs. During the walking period, a burning sensation may appear in the legs.
In case of late treatment of the disease, the occurrence of non-healing trophic ulcers, which are accompanied by pain in the lower leg and foot area, can be diagnosed. Some patients say that they do not have the feeling of cold feet. Also, atherosclerosis may be accompanied by reddening or blanching of the skin in the foot area. Regardless of the gender of the patient, hair may fall out in the calf area. This phenomenon is called alopecia. The severe stage of the disease is characterized by muscle atrophy of the diseased leg.
Symptoms of atherosclerosis are clearly evident in only one tenth of the patients. In other patients, nonspecific changes are observed. That is why when the first signs of disease appear, the patient should seek help from a doctor who will conduct a comprehensive diagnosis and prescribe the necessary medicines.
General treatment recommendations
Treatment of the disease depends on the characteristics of its course.Regardless of the medications taken, the patient needs to change his lifestyle, which will have a positive effect on the elimination of symptoms. The patient, first of all, must go on a diet. During this period, it is prohibited to use:
- Fatty meat
- Fermented milk products,
- Alcoholic beverages, etc.
If the patient has excess weight, then it is imperative to conduct an active fight against him, as this has a negative effect on the disease. The patient should walk only in a comfortable and spacious shoes without heels and wedges. During the treatment of atherosclerosis it is strictly forbidden to smoke and take alcohol. Cut the nails to the patient as carefully as possible.
If there are minor injuries on the lower leg or foot, they should be treated with appropriate solutions. The patient should not allow the feet to be overcooled. Physical activity of the patient should be insignificant. He is strictly forbidden to walk for a long time. It is best to replace walking by swimming or exercising on a stationary bike. In the presence of such comorbidities as diabetes mellitus or hypertension, it is necessary to treat them.
When the patient fulfills all these rules, the process of combating the illness can be significantly accelerated. They are quite simple, which will allow them to easily perform any patient.
In order to eliminate atherosclerosis of the lower extremities as soon as possible, the patient is advised to take certain medication. The most common patients make an appointment:
- Antispasmodic - Drotaverine, with which pain is reduced, as well as the removal of spasms,
- Vasodilators in the form of Trenal, Vazonita, Pentillin, Agapurina, Pentoxifylline,
- Vasodilators in the form of Trenal, Vazonita, Pentillin, Agapurin, Pentoxifylline, Vazaprostan, which have a beneficial effect on the condition of the vessels of the lower extremities,
- Drug medications that improve the nutrition of the tissues in the legs. The most common appointment is Zinktaral.
If the patient has trophic ulcers, then he is prescribed ointments, which include antibiotics. Medicines in the form of Levomekol, Oflokaina, Dimexidum, Delaksina are characterized by a wide spectrum of action. In order to avoid the appearance of blood clots, patients are prescribed anticoagulants in the form of Heparin, Warfarin. Also, these drugs prevent blood from clotting in the vessels.
Medicinal preparations that are characterized by the presence of an antiplatelet effect have a positive effect on the hematopoietic system. Also with their help, blood cholesterol is significantly reduced. In order to increase the physical activity of the patient, drugs such as Cilostazol and Pentoxifylline may be prescribed. They relieve pain in the legs, which allows the patient to walk fully, and also has a beneficial effect on improving blood flow in the lower limbs.
In order to eliminate the possibility of thrombus, doctors make an appointment with anti-platelet drugs in the form of Reopolyglukine or Aspirin. To stabilize the patient's condition, physiotherapeutic procedures can be applied - hyperbaric oxygenation, darsonvalization, electrophoresis, in which Novocain is used.
Drugs are highly effective only at the initial stage of the disease.
If the patient does not go to the medical center in time, the disease has a neglected state, which requires surgical intervention in the form of:
- Endarterectomy, which removes the affected area of the vessel in the lower limb,
- Prosthetics, in which the affected part of the vessel is replaced by an autovene or a synthetic vessel,
- Stenings of the arteries, which consists in placing the tubular strut in a vessel damaged by disease,
- Balloon angioplasty, in which a special balloon is introduced into the vessel to expand the arterial lumen,
- Shunting, which allows you to create an additional path for blood flow,
- Autodermoplastiki, with the help of which the removal of trophic ulcers.
The decision on the use of surgical intervention is made only by a doctor after assessing the patient's condition.
Atherosclerosis of the legs is a rather serious disease that requires a comprehensive approach to treatment. Depending on the severity of the disease, it can be carried out at home or in a specialized center.
Description of the disease
Atherosclerosis is a disease that affects the arteries. The basis of development is the violation of protein and lipid metabolic processes, leading to the deposition of cholesterol on the walls of blood vessels. Clots are gradually formed - so-called plaques that narrow the lumen of the arteries and cause a whole rad of pathological changes.
Normally, blood pumped through the heart freely flows through the vessels, which provides nutrients and oxygen to important organs and all tissues of the body. If the lumen of the arteries is reduced, that is, they narrow, the blood supply and blood circulation are disturbed. Such changes affect the trophism of tissues, the functioning and mobility of individual parts of the body. Most often it affects lower limbs.
Stages of development of the disease
There are several stages of atherosclerosis:
- The first preclinical stage is characterized by the so-called lipoidosis - disorders of lipid metabolism. Cholesterol gradually begins to be deposited on the walls of the arteries as spots, but there are practically no clinical manifestations. Some patients have discomfort and discomfort after a long walk.
- In the second stage, the formation of plaques begins, the lumen of the vessels decreases. There are more obvious symptoms, due to which it becomes difficult for the patient to walk more than 500-1000 meters on foot.
- At the third stage, the plaques increase in size, partially overlap the arteries, ischemia (blood supply failure due to inadequate blood flow) occurs, impairing mobility. Already after 40-50 meters of walking a pronounced pain syndrome develops.
- At the last stage, the lumen of some vessels may completely overlap. Necrosis of tissues begins, external manifestations occur: ulcers, areas of tissue necrosis.
The exact causes and mechanism of atherosclerosis are unknown, but several negative factors stand out, the effect of which increases the risk of developing the disease. These include:
- Genetic predisposition. Often, atherosclerosis is diagnosed in members of one family or close relatives.
- Bad habits. Thus, nicotine, which enters the body of a smoking person, provokes a spasm of blood vessels, which increases the risk of deposition of cholesterol on their walls. Alcohol abuse also has a negative effect on blood circulation and metabolism.
- Improper nutrition. Cholesterol can be ingested with food, and its content in fats of animal origin is especially high.
- Excessive weight significantly increases the load on the arteries and slows down lipid metabolism.
- Some concomitant diseases, such as hypothyroidism, hypertension, diabetes.
- Sedentary lifestyle. With a decrease in physical activity, lipid metabolism slows down, the blood supply to the lower limbs deteriorates.
- Inflammatory diseases of the blood vessels, such as varicose veins, phlebitis, thrombophlebitis.
- Frequent and severe stress, provoking spam and vasoconstriction.
It is useful to know: more often, atherosclerosis is diagnosed in men (but often also occurs in women), and with age the risks of its development increase markedly.
If you do not treat atherosclerosis of the legs in a timely manner, the lumen of the arteries will narrow so much that there is a risk of occlusion and complete blockage of the vessels. If the blood stops flowing to the lower extremities, they will completely lose their sensitivity and mobility. Lack of blood supply will lead to tissue necrosis, non-healing trophic ulcers will begin to appear. A dangerous consequence is gangrene, which requires immediate amputation. Atherosclerosis is extremely dangerous and insidious, and in advanced cases it can be fatal.
Prevention of atherosclerosis involves adherence to several rules:
- Proper nutrition.
- Moving lifestyle.
- Regular examinations, timely treatment of diseases.
- Weight loss.
- Foot massage.
Atherosclerosis is dangerous, so it is important to know its symptoms in order to be able to timely identify and cure the disease.
The main reason for the development of atherosclerosis obliterans of the legs (having the code I70.2 according to ICD 10 - the international classification of diseases) is a violation of lipid metabolic processes, as a result of which harmful cholesterol is deposited on the vessel walls, forming a kind of plaque. The walls thicken, and the clearance decreases. This is also the case with ordinary atherosclerosis of the blood vessels, and with obliterating the chronic form develops.
What are plaques? They have a complex structure. At the beginning of the development of pathology, connective tissue grows, which is covered with atheromatous masses consisting of low-density lipoproteins. Next, calcium is formed, and the plaque is calcified.
In the obliterating form of atherosclerosis, blood vessels that are of a muscular-elastic type are affected. The overlap of the lumen is carried out gradually.
Classification of obliterating atherosclerosis of vessels of the lower extremities
Pathology proceeds in the following stages:
- Primary (preclinical) atherosclerosis is characterized by the absence of symptoms. You can diagnose by accident. Examination reveals only fat.
- Weak form - the first signs appear. On examination, cholesterol stains are visible. The treatment prognosis is favorable.
- Strong stage - plaques are formed, the lumen is narrowed. Symptomatology pronounced. Complications develop.
- The last stage is pronounced. At this stage of the disease, atherosclerotic plaques come off, spreading through the vessels. Possible complete blockage of veins and rupture of blood vessels.
According to the prevalence, there are five degrees of atherosclerosis:
- The disease is localized in only one place.
- There is a spread on the arteries located in the hips.
- Popliteal veins are involved.
- All of the above arteries are completely affected.
- Deep damage occurs, all vessels are affected.
Symptoms, clinical picture
The general symptoms of atherosclerosis obliterans in the leg vessels is as follows:
- muscle pain,
- pain in places of affected veins in a state of physical activity, and after a while - and in a state of rest,
- limp after physical work or walking,
- numbness of the limbs, peculiar pricking,
- limited mobility of the legs,
- cooling of the lower limbs and constant feeling of cold,
- loss of hair in places of defeat,
- nail plates become excessively thickened,
- toes covered with purple spots,
- ulcers form on the skin.
Additional signs of pathology depending on the severity of the disease:
- at the initial stage, “running goosebumps” are felt, the skin turns pale, sweating appears,
- in stage 2, pain develops after two hundred meters, which the patient passes,
- for stage 3, pain is characteristic even at rest,
- wounds, ulcers and gangrene are formed in 4 stages.
Therapy of the disease is aimed at diluting the blood fluid, eliminating pain, accelerating the blood circulation process, strengthening and expanding the walls of blood vessels. In addition, it is necessary to achieve the normal functionality of collaterals, strengthen the immune system, activate metabolic processes and neutralize all the symptoms. Therefore, treatment should be extremely complex.
Drug therapy involves taking the following groups of drugs:
- Statin group normalizes the level of harmful cholesterol in the blood liquid. Known remedies: Rosuvastatin, Fluvastatin, Lovastatin, Mevacor, Kvantalan, Zokor, Cholestyramine.
- Antispasmodic drugs eliminate pain in the vessels: "Halidor", "Nikoshpan", "Doverin", "Avisan", "Papaverine", "Libraks", "No-shpa".
- Anticoagulant group is designed to reduce blood clotting. Well-known drugs: "Aspirin", "Cardiomagnyl", "Heparin", "Trombot ACC", "Tiklid", "Warfarin".
- Angioprotectors accelerate circulation, metabolism in tissues and normalize the rheological properties of the blood biological fluid. These are “Indovazin”, “Troxerutin”, “Antistax”, “Venodiol”, “Detralex”.
- Drugs that activate the metabolic processes: "Actovegin", "Pentoxifylline", "Trental", "Solcoseryl", "Curantil", "Complamin".
- Vitamin therapy involves the use of vitamins B, E, C, A.
Required are also such events:
- The patient must eat right and follow the diet prescribed by the attending doctor.
- Therapeutic walking. Three times a week, the patient should walk from 30 to 60 minutes. Due to this collateral veins are included in the work.
- Physiotherapy procedures. This may be electrophoresis, UHF, laser or magnetic therapy, the effects of microcurrents, ozone therapy, hyperbaric oxygenation.
- Bathing with additives in a physiotherapy room.
- Pneumo-pressotherapy is also used, in which the patient is placed horizontally, and a special cuff is put on the affected limb. Air is blown into and out alternately. Thus, a certain pressure is created, due to which the muscle system is massaged. This leads to the expansion and contraction of blood vessels and further restoration of normal blood circulation.
In order to avoid the development of obliterating atherosclerosis in the lower extremities, it is necessary to adhere to the following preventive measures:
- Pay special attention to your diet. Harmful cholesterol enters the body with food. Therefore, avoid excess salt, animal fat, excessively spicy foods, fried and smoked dishes. Harmful cholesterol is found in high-fat dairy products, red meat.
- Be sure to wear comfortable and comfortable shoes, because it affects the condition of the blood vessels and blood circulation itself.
- The same applies to tight clothing, underwear.
- Do not cross your legs when sitting.
- Every day at least 30-40 minutes walk on foot.
- Watch for blood pressure.
- Exercise, but not excessive.
- Do not abuse alcoholic beverages and do not smoke.
- Seek qualified help from specialists in a timely manner - treat chronic pathologies, pay attention to the symptoms.
The obliterating form of atherosclerosis of the leg vessels carries with it the threat of gangrene and loss of limbs. With timely treatment in the clinic and adequate treatment of such effects can be avoided. Therefore, monitor the state of the circulatory system and follow simple preventive rules.