Obliterating atherosclerosis

Obliterating atherosclerosis among other diseases of peripheral vessels occupies a leading position.

Most often, the disease affects men over forty. Obliterating arteriosclerosis often causes severe ischemia, dooming patients to very painful suffering. At the same time, many patients are unable to work. Most obliterating arteriosclerosis of the arteries of the lower extremities is noted. The process can be localized in the aorta. In addition, often the disease affects the mid-caliber arteries - the femoral and popliteal.

Obliterating atherosclerosis of vessels of the lower extremities is associated with the same etiological factors and pathogenetic mechanisms that provoke the disease of other localization.

The main changes are noted in the circumference of the foci of lipoidosis. There is a fresh connective tissue. Ripening, it leads to an increase in fibrous plaque. In these formations, clots of fibrin and platelets settle. Abundant lipid accumulation provokes a blood circulation disorder in the plaques. Their necrosis causes, in turn, the formation of an athere. Contained in their cavities atheromatous masses fall into the lumen of the vessel. Tearing themselves distally, they can provoke embolism.

At the same time, in the affected tissues of plaques, in the areas of elastic fibers that experience degeneration, calcium salts begin to be deposited. Thus obliterating atherosclerosis passes in the last stage.

Throughout the disease there are four stages.

Obliterating atherosclerosis for several years can develop without any manifestations. However, since the appearance of the first clinical symptoms, it often very quickly progresses.

In some cases, due to thrombosis, the manifestations of the disease are characterized by suddenness. In the anamnesis often in patients with hypertensive disease, heart attacks, angina attacks, diabetes mellitus, cerebral circulatory disorders.

Symptoms of the disease should include intermittent claudication, which is manifested by painful gastrocnemius muscles. Sensations, as a rule, arise during walking and pass after a short rest.

Atherosclerotic lesions of the iliac arteries and the terminal area of the abdominal aorta provoke localization of pain not only in the region of the legs, but also the buttock femoral muscles, as well as in the lumbar zone. Strengthening of intermittent claudication is noted when climbing a mountain or a ladder.

Typical manifestations are a feeling of chilliness, an increase in the sensitivity of the feet to the cold, numbness of the feet. As a result of ischemia, the color of the skin of the lower extremities changes. At the beginning of the development of the disease they acquire a pale color. With the course of the disease, the skin of the fingers and feet becomes purple-cyanotic.

Trophic disorders disrupt the growth of nails, contribute to hair loss.

Progression of the disease is characterized by ulcerative necrotic changes in the soft tissues of the distal zones of the affected limbs. This marked swelling and hyperemia of the feet. With occlusion of the aortic iliac region, a characteristic symptom is impotence caused by a disorder in the circulation.

Patient examination often reveals muscle atrophy or malnutrition in the lower limbs.

Often there is a lesion of the femoral-popliteal segment, which is manifested in the absence of pulsation either on the arteries of the feet or on the popliteal artery from the site of the deep thigh artery.

The main method of diagnosis is angiography. This method allows to reveal the extent and localization of the pathological process, the level of vascular lesions, to characterize the collateral circulation, and also to assess the state of the distal blood flow channel.