What is lower limb angiopathy? How to treat it?

Angiopathy refers to a group of pathologies associated with damage to vascular structures and impaired circulation. The development of the disease occurs gradually: the arteries and veins lose their tone, the lumens inside them narrow. As a result, the bodies experience a shortage of food. Angiopathy of the lower extremities is diagnosed mainly in patients with diabetes mellitus. The lack of adequate therapy can lead to amputation and even death. To avoid such complications, you need to know what symptoms are accompanied by pathology and when to go to a doctor.

Angiopathy is a symptom or a disease?

Virtually all the vessels in the human body can be prone to pathological changes. Of particular interest is the defeat of the microcirculatory structure, which is represented by a multitude of plexuses. Speaking of angiopathy, most often refer to the pathology of the lower extremities. With such a diagnosis, even absolutely healthy people have to face. Why is this happening? This phenomenon can be explained by the lack of mutual understanding between different specialists and overly impressionable patients. The latter, after hearing an unknown diagnosis, immediately panic.

It should be clearly understood that the described deviations can not be an independent disease. Angiopathy is a manifestation or complication of certain functional disorders in the functioning of the body. In its essence lies the decrease in elasticity and the decrease in the lumen of the vessels. As a result, there are symptoms of circulatory disorders in the tissues. Such a clinical picture is typical for damage to the muscular layer of the vascular wall or changes in its innervation. In this case, there is a spasm with a simultaneous slowing of the blood flow velocity.

The main causes of angiopathy

Doctors identify a number of factors that contribute to the onset of the pathological process. Among them, diabetes takes the first place. Angiopathy of the lower extremities in 70% of cases develops against the background of excess sugar in the blood. The second place belongs to hypertension. With severe symptoms of the disease, the arteries and capillaries cease to cope with the functions assigned to them. Gradually, the walls of the vessels are covered with fat, the blood becomes thicker. Together, these factors provoke the development of angiopathy.

Among other causes of the pathological process can be noted:

• smoking;
• Work with toxic materials;
• Hypotension;
• Congenital disorders in the circulatory system;
• Hereditary predisposition.

Treatment of angiopathy depends on the timeliness of the diagnosis. That is why it is important to be able to recognize the signs of an illness at an early stage.

What forms does lower extremity angiopathy have?

ICD-10 (International Classification of Diseases) assigned this pathology code 179.2. In its current, it is customary to distinguish two forms:

1. Microangiopathy (lesion of small vascular formations). It is often combined with retinal dysfunction, renal blood flow disorder.
2. Macroangiopathy (defeat of arterial structures of medium and large caliber). This violation is typical only for the vessels of the extremities.

Each form of pathological process has a certain clinical picture.

Symptoms of microangiopathy

At the initial stage, the microangiopathy of the lower limbs practically does not manifest itself. However, when examining the vessels, they already reveal certain changes, which in time begin to bring discomfort. The skin becomes pale, and the touch is cold. On the feet appear small sores, which very quickly spread to new areas. The patient may be disturbed by unpleasant sensations, pain after physical exertion. Around the jaundice, the skin acquires a reddish hue, puffiness. The penetration of the pathological process into the muscle or bone tissue is accompanied by the appearance of phlegmon. Necrotic sites gradually go beyond ulcers, extending to the fingers. With the defeat of the entire foot, the only way to save a leg is to amputate a part of it.

Symptoms of Macroangiopathy

The development of pathology also occurs gradually. First, patients complain of stiffness in the legs in the morning. Then discomfort does not disappear throughout the day and is supplemented by numbness in the fingers. Legs are always cold, sometimes there is intermittent claudication. The skin becomes pale. Intermittent claudication becomes more pronounced day by day. To all the symptoms are added severe pain in the legs, convulsions. Unpleasant sensations (burning, tingling) do not leave the patient even during rest. Later, edema and sores appear with signs of necrosis. In the pathological process, all new sites are gradually involved. Macroangiopathy of the lower extremities is often accompanied by an increase in temperature, a general weakness.

What is the risk of angiopathy in diabetes mellitus?

Pathological changes in the vessels of the extremities are a frequent companion of patients with diabetes mellitus. Atrophy and circulatory disturbances in the foot are a consequence of loss of capillary capacity. Excess sugar in the blood gradually destroys the walls of the vessels. In some parts they become thinner, in others they thicken. As a result, the lumen of the vessels narrows, and the tissues die on the background of oxygen starvation. As the disease develops, fingers firstly atrophy, then the entire foot, shin and thigh. Affected structures require immediate amputation, as gangrenous processes occur in them. In this case, the pulsation in the limbs is often observed.

Diabetic angiopathy of the lower limbs is the most serious complication faced by patients with insulin deficiency in the blood. It is recommended to carry out prophylaxis immediately after confirmation of the diagnosis.

Modern diagnostic methods

If you suspect a lower extremity angiopathy, the first step in the diagnosis is to collect the patient's anamnesis and examine the affected areas. After that, they pass to laboratory research using high-tech devices:

1. MRI. Allows you to evaluate the structure of soft tissues.
2. Ultrasound. Doppler study helps to determine the condition of the walls of blood vessels, and duplex scanning - the speed of blood flow.
3. Angiography. X-ray diagnostics with the use of contrast medium allows visualizing the patency of vessels.
4. CT. Used to study pathological sites of extremities.

The application of these diagnostic methods is necessary to obtain a general picture of the pathological process, to evaluate the degree of vascular damage. The examination of the patient also makes it possible to determine to what form the angiopathy of the lower extremities belongs.

Treatment: medicamentous and surgical

The methods of treatment of angiopathy depend on the causes that provoked its appearance. In the early stages, sometimes even a simple adjustment of diet and lifestyle leads to a slowing down of the pathological process. What other treatment options are available?

1. Drug therapy. Patients with a diagnosis of "angiopathy of the lower extremities" prescribe drugs to improve the tone of blood vessels and normalize blood pressure. It is also recommended to take medications that stimulate blood circulation processes (Actovegin, Escuzan, Heparin). All medicines are selected individually, taking into account the general clinical picture of the disease.
2. Lymphomodulation. Conducting special procedures helps to improve the circulation of blood and lymph in the body, the rapid excretion of metabolic products. After several treatment sessions, the swelling of the skin in the affected areas is markedly reduced.
3. Operation. Surgical intervention involves the plastication of tissues and the reconstruction of altered vessels. In especially serious cases, when the necrotic process has spread to the entire foot, amputation is indicated.

Timely access to a doctor allows you to suspend the course of the pathological process and avoid surgical intervention. Sad statistics show that in 10% of cases, blood infection leads to death.

Treatment with folk remedies

Traditional healers offer their own prescriptions for the treatment of such an ailment as angiopathy of the lower extremities. Symptoms and manifestations of the pathological process at the initial stage usually do not cause inconvenience. If they are recognized in a timely manner, further progression of vascular disorders can be prevented. It should be noted that the treatment of folk remedies must be combined with traditional methods.

Znachari offer to treat the use of plants that promote the normalization of metabolism. These are ginseng, aralia manchurian, levzeum safflower and others. From these plants you can prepare decoctions and tinctures. To improve carbohydrate metabolism, healers are advised to add leaves of medicinal dandelion and elecampane to tea. Coffee should be replaced with chicory. It must be dried, roasted and grinded. The leaves of the plant can be used for dressing salads.

Treatment of angiopathy in diabetes mellitus

Earlier we already told you what symptoms are accompanied by angiopathy of the lower extremities. In diabetes mellitus, the treatment is practically the same as in case of other causes of the pathological process. The basis of drug therapy are drugs that contribute to the improvement of blood clotting. The glucose values are regulated by the introduction of insulin. Additional therapeutic effect is given by physiotherapy. For example, treatment with mud and plasmapheresis makes it possible to purify the blood.

In neglected cases resort to surgical intervention. At the initial stage of pathology development, lumbar sympathectomy is used. A positive effect is also provided by reconstructive operations, thanks to which it is possible to normalize microcirculation. The initiated angiopathy of the arteries of the lower extremities, accompanied by gangrene, requires amputation. After the rehabilitation course, the patient is made a high-quality prosthesis.

Preventive measures

With diabetes or hypertension, prevention of angiopathy should be started immediately after confirmation of the diagnosis. For this, it is recommended that you periodically take tests and undergo a medical examination. It is important to constantly monitor blood sugar, monitor blood pressure and veins. Diabetic angiopathy of the vessels of the lower limbs requires immediate treatment when the first symptoms of the disease appear. The course of therapy should appoint a doctor.

In addition, the prevention of pathological changes in blood vessels includes the following measures:

• Refusal to smoke and other addictions;
• Employment by feasible kinds of sports;
• Strengthening immunity and CNS;
• balanced diet;
• Fighting overweight.

The most important thing is a positive attitude. It is he who, as a rule, has a decisive influence on the process of recovery.