Atherosclerosis of the vessels of the lower extremities: symptoms, treatment, causes, prevention

What is it - one of the most common chronic systemic diseases, is the atherosclerosis of the vessels of the lower extremities.

The disease is characterized by occlusive vascular lesions of the limbs, leading to various trophic changes in the tissues.

The mechanism of formation of

The most important vessel of the human arterial system is the aorta. It consists of three sections - the ascending part, the arc, and the descending part of the aorta. The descending part includes the thoracic and abdominal parts. The thoracic aorta rarely affects atherosclerosis, in contrast to the abdominal part.

In most cases, local lesion with atherosclerosis begins precisely in the abdominal area, where the aorta splits into the iliac arteries with further branching to the femoral, popliteal and ankle arteries. This part is the most susceptible to atherosclerosis.

The deposition on the vascular walls of a conglomerate consisting of cholesterol( see causes of increased cholesterol) fat and protein lipoprotein fractions, cause a narrowing of the lumen in the vessels.

The absence of treatment promotes the development of atherosclerotic plaques, which entails complete blockage of the vascular intima, which blocks blood circulation in the affected area of ​​the vessel. This pathology causes oxygen starvation of tissues with possible development of trophic ulcers and gangrenous lesions. This process is subject to any age categories.

Especially manifested in senile age, the predominant majority are men, but in children there are manifestations of lipid spots on the walls of the vessels, as the first signs of atherosclerosis of the lower limbs.

Causes of atherosclerosis of lower extremity vessels

There is no single causative factor, there are only supposed versions. The cause can be caused by conditions caused by:

1. 1) Tangier disease - aldipipoproteinemia
   
2. 2) Endothelial dysfunction and loss of protective anti-atherogenic properties;
   
3. 3) The manifestation of monocytosis, Chediak-Higashi syndrome( cellular insufficiency) and chronic granulomatous disease;
   
4. 4) Pathological condition of smooth muscle tissues of vessels as a result of cell transformation;
   
5. 5) Viral endothelial viral injury;
   
6. 6) Defect( bundles of vascular wall tissues) of a hereditary character;
   
7. 7) Cytogenetic disorders as a result of chronic exposure to ionizing radiation
   
8. 8) Effects on blood vessels of toxins, viruses and bacteria;
   
9. 9) Imbalance in the production of gonadotropic hormones that provoke an intensified process of producing estrogen, progesterone or testosterone.

Provocative factor in the development of the disease is:

• hypertensive states( see symptoms of hypertension);
  
• excessive weight;
  
• VSD and addiction to smoking.

The tibial, femoral and popliteal arteries are most affected by atherosclerosis. The formation of cholesterol plaques causes occlusion( complete closure) or partial constriction of the vessels, which prevents or hampers the blood supply of the tissues of one lower limb or both, causing ischemia and the manifestation of pain symptoms.

The process of converting lipid deposits into a plaque of atherosclerosis, consists of several phases of development.

1. 1) The first phase, called liposclerosis, is characterized by fibro-atheromatous formations on the vascular walls as a result of fibrous tissue overgrowth around the lipid masses deposited on them
   
2. 2) The second phase is atheromatous, characterized by thrombotic formations in the ulcerated center of fibrous atheromatous formation located on the wallsblood vessel.
   
3. 3) The third phase is atherocalcinosis. The final phase of transformation with the deposition of calcium salts.

As a result of such "metamorphosis", the vessel walls are completely blocked( obliterated) or thrombosed, causing blood circulation in the tissues to fail.

Read also how to treat lymphostasis of the lower extremities.

Classification of the disease

Insufficiency of peripheral circulation causes the development of protrusion of arterial walls( aneurysms), the formation of lateral or bypass routes of blood flow( colloter), blockage of peripheral arteries in the extremities( emboli), and the development of acute thrombosis.

The development of disturbances in the blood supply of the limbs, depends on arterial insufficiency, leading to the possible development of tissue ischemia and necrotic changes in tissues. And it is determined by four stages of development.

1. 1) In the initial stage of the disease, with angiography, narrowing in the arterial lumens and characteristic thickening of the vascular walls can be determined. Characteristic of the absence of pulsation in the vessels of the limbs, prolonged walking can be affected by pain in the legs.
   
2. 2) The second stage is manifested by ischemic pain in the caviar muscles and in the buttocks( intermittent claudication), manifested with insignificant loads. Studies of the arteriogram determine the development of bypass blood flow and narrowing of arterial walls in the branching of the femoral or popliteal artery.
   
3. 3) The third stage is characterized by severe ischemia, due to oxygen starvation of tissues. Is manifested by constant pain, increasing even with minor physical exertion.
   
4. 4) Surgical treatment is inevitable in the fourth stage, as, as a consequence of atherosclerosis, there may be trophic ulcers and necrosis on the foot and in the area of ​​the fingers with the risk of developing gangrene

. Also read the symptoms and treatment of cerebral artery atherosclerosis.

Symptoms of atherosclerosis of lower extremities vessels

Initial manifestation of symptoms is insignificant. It shows only minor pain in the legs and light lameness. The development of atherosclerosis of the vessels of the lower extremities causes an aggravation of symptoms.

Occlusion of the arterial wall in the ileum region has such signs:

• by chillness of the legs;
  
• by changing the skin of the legs( pallor and marble shade);
  
• cornification of the skin
  
• with hair and nail growth;
  
• in the late stages - the skin becomes purplish-cyanotic;
  
• with severe pain in the thigh and buttocks;
  
• development of gangrene on the feet.

In femoral occlusion, pulsation on the thigh persists, but is significantly weakened on the foot and lower leg. Vascular lesions of the lower leg are characterized by a complete absence of pulsations in the ankle, although in the femoral and popliteal region the pulsation persists. Are manifested:

• pain and numbness in the feet and fingers;
  
• development of fungal infections between the fingers;
  
• with long-term non-healing wounds.

If you have any of the above symptoms, you should immediately call your doctor.

See also, thrombophlebitis of the veins of the lower extremities.

Diagnostics

Modern diagnostic methods detect atherosclerosis of the lower extremities, even in the initial stage of its development.

1. 1) Atherosclerotic occlusion and the level of damage to blood circulation in blood vessels, is determined by duplex scanning of arterial vessels in the lower limbs.
   
2. 2) The CT-angiography method allows to obtain a complete, layer-by-layer characterization of the state of vascular tissues.
   
3. 3) The determination of the degree of vascular lesions, the location of the localization and the extent of the pathological process, is done with the help of X-ray angiography.

Treatment of atherosclerosis of the lower extremities vessels

Atherosclerotic lesion of the lower extremities is treated by a complex method directed, first of all:

• to reduce the impact and control of causative factors;
  
• decrease in the degree of vascular lesion;
  
• treatment of complicated processes.

The main methods of treatment of atherosclerosis of the vessels of the lower extremities are the methods:

Conservative treatment aimed at lowering cholesterol level, treating background diseases, medicamentous use in the treatment of complications at any stage of the disease.

Surgical treatment. It is used in the progressing stage of atherosclerosis, with the use of various operating procedures to avoid amputation. Methods are used - shunting of the vascular arteries, minimally invasive surgery, with the use of intravascular operations. For example, balloon dilatation of vessels with an introduction that supports and prevents re-contraction of the implant.

The most effective prophylaxis for this disease is elimination of causative factors:

• avoid overeating;
  
• if you can not quit, then at least minimize smoking;
  
• not to abuse alcohol
  
• to balance the diet, eliminating animal fat from the diet.

It should be remembered that a neglected disease is much more difficult to treat.

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