Arteritis of the lower extremities
Cases of arteritis of the lower limbs are counted every year. This disease causes a blockage of the arteries that supply the lower limbs.
It is mainly caused by an accumulation of cholesterol in the arteries.
Arteritis of the lower limbs is a cardiovascular disease. It is characterized by partial or total blockage of the arteries of the lower limbs.
According to the health insurance, more than one in five people over 70 years old are affected by this pathology.
Also called arterial oblique disease of the lower limbs (AOMI), this disease reduces the blood and oxygen supply to the limbs: therefore, the muscles are no longer oxygenated.
Arteritis of the lower limbs: what are the causes of this disease?
Blood from the heart flows to the lower extremities through various arteries such as the aorta, iliac, femoral, and pedal arteries. Several factors can promote the development of lower extremity arteritis:
- excess cholesterol
- high blood pressure
- overweight and obesity
- Lack of physical activity and sedentary lifestyle.
- excessive alcohol consumption
- the male sex
In 90-95% of cases, lower limb arterial obliterating disease is caused by atherosclerosis. Atherosclerosis can cause an occlusion that blocks the arteries or lead to a stenosis that narrows them.
Atherosclerosis is an accumulation of cholesterol in the arteries.
These deposits cause atheromatous plaques on the inner lining of the artery. They produce inflammatory reactions and can lead to serious complications such as..:
- Progressive tissue ischemia: atheromatous plaques increase in volume and reduce the diameter of an artery. This phenomenon blocks the blood flow and the tissues receive less oxygen.
- Ischemic accidents: can occur when the atheromatous plate breaks. Fragments can then migrate into the arteries and block them.
- an arterial thrombosis: a blood clot forms and blocks an artery
The arteries of several organs can be affected by atherosclerosis, including the coronary arteries of the heart, the carotid arteries from the neck to the brain, the abdominal aorta, the digestive, renal and lower limb arteries.
How does arterial disease obliterans of the lower limbs develop?
When it begins to develop, arteritis of the lower limbs is asymptomatic. There is no indication of its presence. It is often identified by the systolic pressure index.
For this test, systolic blood pressure is measured in the wrists/arms and ankles. If it is less than 0.9, oblique arterial disease of the lower limbs is declared. This cardiovascular pathology can evolve in four stages:
Stage 1: the infraclinic
There are no clinical signs in the affected patient. When lower limb arteritis is reported, treatment should be immediate to avoid serious complications.
Stage 2: Intermittent Claudication
When the patient walks, the first pains in the calf begin to appear. He is forced to stop to calm them down. If the iliac artery is blocked, pain appears in the buttocks and hips.
Stage 3: Pain at rest
If arteritis of the lower limbs is not treated, the patient feels the painful genes when lying down or sitting down. They often get up during the night.
Stage 4: Trophic disorders, ulcerations and gangrene
This last stage is the most serious. The lack of blood supply causes severe pain in a limb or a limb.
He becomes increasingly pale and cold, sometimes with diminished motor skills. This is a medical emergency. If the arteritis is not treated in time, the limb will have to be amputated.
Arteritis of the lower limbs: how is it diagnosed?
Treatment of lower limb arteritis should be quick, as there are serious complications.
According to the French Federation of Cardiology, a complete vascular checkup is necessary to identify the other locations of atherosclerosis at the level of the different arteries.
To make the diagnosis, the health professional performs an arterial Doppler ultrasound to detect the affected arteries and the degree of damage. The patient may also be prescribed a stress test, a myocardial exploration and a coronary angiogram.
What are the treatments for lower limb oblique artery disease?
Treatment of lower extremity arteritis is based primarily on a healthy lifestyle and treatment of risk factors.
Therefore, health professionals recommend quitting smoking, losing weight if necessary, getting regular physical activity and eating a balanced diet. For patients suffering from hypertension, medication treatment is also prescribed.
When this fails, surgical treatment is required to treat arterial disease obliterans of the lower limbs. An interventional physician or vascular surgeon can perform various techniques such as :
- Dilation of the artery with or without a stent.
- A thigh bypass
- A lumbar sympathectomy
In some cases, these interventions may not work. As a last resort, the specialist will have to amputate the affected limb to save the patient’s life.
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