Atherosclerosis of the legs is a serious pathology of large arteries of a chronic nature, resulting from impaired lipid metabolism.
What factors provoke its development? What is the cause most often? What symptoms indicate the presence of this disease? And how to treat it? This will be discussed now.
Causes
Atherosclerosis of the legs manifests itself in a violation of the passage of blood through the vessels and in the occurrence of tissue trophism. As a rule, the disease affects large arteries of the chest and abdominal cavity. And this leads to pathological changes in the femoral, tibial and popliteal arteries. In them, the clearance is reduced by as much as 50-55%, and sometimes more.
As a rule, this disease is encountered by people suffering from aortic aneurysm, coronary heart disease, or those who have damage to the vessels of the lower extremities and the brain.
Here are some well-known factors that provoke the development of this ailment:
- The abuse of nicotine. This substance leads to spasms of arteries, and therefore prevents blood from passing through the vessels. The result is either atherosclerosis or thrombophlebitis.
- Excess weight.
- Abuse of fatty foods. This is fraught with an increase in cholesterol.
- Diabetes mellitus, arterial hypertension, decreased production of thyroid hormones, etc.
- Chronic stress, depression, excessive psycho-emotional stress.
- Heredity.
- High blood pressure.
- Old age.
- Decreased motor activity.
It should also be noted that atherosclerosis of the vessels of the legs most often affects men.
Stages and Symptoms
Atherosclerosis of the lower extremities of the legs develops in four stages:
- First. Symptoms: fatigue in the calves, felt after prolonged physical exertion. Trophic disorders also appear - a feeling of cold legs and chilliness.
- Second. Symptoms: aching and pain in the legs, appearing literally after 150-200 meters passed. The sensations are similar to the manifestation of angina pectoris. Also, a person notices increased fragility of hair on the skin of the lower extremities, peeling, increased sweating and incomprehensible white spots. Over time, pain occurs more often. Normal walking alternates with lameness.
- Third. The patient is faced with formidable ischemia of "rest". Even complete rest in the muscles cannot provide a full flow of nutrients and oxygen. After walking 5-10 meters, a person feels the same pain as before at a distance of 200 m. The following symptoms appear: impaired passage of motor and sensory impulses, numbness, decreased temperature and skin sensitivity, a feeling of "goosebumps", foliation of nails. Abrasions and cracks also stop healing. Some parts of the foot acquire a bright copper color.
- Fourth. At this stage, pain in the legs with atherosclerosis becomes unbearable. Massive tissue necrosis is observed, often wet or dry gangrene occurs . Sepsis, cachexia, intoxication appears.
The very first early symptom of this disease is chilliness in the feet and fingers, as well as increased sensitivity to cold, which provokes the desire to wear warm socks. The arterial pulse on the feet may also disappear.
Diagnostics
To identify this disease, it is necessary to conduct a comprehensive diagnosis, which includes:
- Identification of specific symptoms.
- Identification of risk factors that could provoke the development of the disease.
- Laboratory research.
- Instrumental diagnostics.
Before this, a palpation examination of the lower extremities is performed. During the examination, attention is drawn to a decrease in the hairline, weakening of the pulse, atrophy of muscle tissue, a slowdown in the growth of nail plates and their thickening.
Also a typical symptom is blanching of the foot when lifting and bending the foot, which sharply turns red when it returns to its original position.
Another angiologist must determine the ankle-brachial index, measuring and comparing systolic pressure in both areas.
The doctor, having carried out all the necessary measures, is able to detect the disease even in an asymptomatic course. From laboratory research perform:
- Analysis of total cholesterol.
- Study of triglyceride levels.
- Determination of the level of "bad" and "good" cholesterol (LDL and HDL).
- Analysis of the atherogenic index.
- A study of c-reactive protein, creatinine levels, and renal filtration rate.
To confirm the diagnosis using instrumental methods. As a rule, these are ultrasound, MRI, radiopaque angiography and ultrasound examination of the thickness of the inner layer of the vascular wall.
Consequences and Complications
Atherosclerosis of the legs is a disease that you need to pay attention to at its first manifestations. In no case should you ignore the symptoms. Otherwise, there will be a trophic ulcer of the lower leg or foot. This is fraught with an irreversible loss of limb functions. And ulcers that do not heal for a long time have a tendency to malignancy (turning into a malignant formation).
Necrotic complications also appear, gangrene can begin to develop rapidly. Failure to take appropriate measures results in death.
Operation
Atherosclerosis of the vessels of the legs in the first stages is amenable to medical treatment. But if the disease is complicated, then surgery is prescribed.
Blockage of arteries can be done through a bloodless operation. Available in the form of angioplasty. During this operation, a special balloon coated with a drug is injected into the artery, which is instantly absorbed into the vascular walls. Inflammation is eliminated, and the diameter of the tubular organs is normalized. Blood begins to flow freely to all areas of the lower extremities.
This operation has a lot of advantages. To enter the balloon, you need a small puncture. Also, general anesthesia, quite local, is not required. The operation is carried out quickly, and the patient begins to walk the very next day. In addition, the probability of joining the infection is zero.
With obliterating atherosclerosis of the legs, you can say goodbye by having a shunt. Having established an intravascular prosthesis, it is realistic to prevent the formation of plaques and the appearance of unpleasant consequences. But for this operation, it is necessary to make an incision in the upper thigh.
Bypass surgery also helps to get rid of blockage in large areas. In such cases, multi-story shunts are made, which make it possible to alternate healthy areas with prostheses.
However, this operation is not shown to everyone. You can not do it in case of hypertension, edematous syndrome, angina pectoris, with myocardial infarction, etc.
Also, shunting and other operations are meaningless if the patient has lost motor activity. In this case, the only true decision that can save a personโs life is made - to make amputation of the leg.
Sequestrants of bile acids
Preparations of this group are prescribed for the treatment of atherosclerosis of the legs. They help cope with a moderate increase in cholesterol. Sequestrants adsorb bile acids in the stomach. Thus, the liver loses them. And as a result, it begins to synthesize acids from cholesterol. As a result, its amount in the body decreases.
To mitigate the symptoms of atherosclerosis of the legs, as well as to improve the condition of the patient, the doctor may prescribe such drugs:
- "Kolestipol" ("Kolestid").
- "Quantalan."
- "Questran".
- "Cholestyramine."
A specific drug is prescribed only after analysis. Because there are contraindications and there may be side effects. Among them: bleeding from the gastrointestinal tract, skin rashes, dyspepsia, heartburn, pancreatitis, diarrhea, nausea, vomiting, etc.
Statins
In the treatment of atherosclerosis of the legs, drugs of this group are also taken. Using them, you can reduce the synthesis of liver cholesterol. These are very effective drugs that are prescribed even to people who suffer from hypertension, diabetes, coronary heart disease and angina pectoris.
But statins have a number of side effects. The doctor before prescribing any drug in this group weighs all the risks, and also assesses the potential benefits. Such means may be prescribed:
- "Simvastatin." Reduces cholesterol concentration by 38%.
- "Pravastatin." Reduces LDL concentration by 54%. The speed of action and indicators increase with increasing dose.
- Mekavor. The action and composition is similar to the previous drug.
- "Holetar." Minimizes total cholesterol levels in the blood, as well as LDL. Also increases the amount of high density lipoproteins. Eliminates inflammation, reduces the risk of blood clots and stabilizes plaques already present in the lumens.
Among the side effects, the following manifestations can be noted: flatulence, pancreatitis, hepatitis, skeletal muscle inflammation, sleep disturbance, anemia, allergies, decreased potency, blood clotting disorders and myopathy.
Fibrates
When treating atherosclerosis of the toes, you need to take drugs of this group. Fibrates help reduce the formation of fats in the body. They are effective, but also increase the risk of gallstones and, in general, negatively affect the liver.
There are only two popular means of this group:
- Clofibrate. Blocks cholesterol biosynthesis and contributes to its breakdown. It dilutes blood and prevents platelets from sticking together. Side effects may include vomiting and diarrhea, muscle weakness, stagnation of bile, and a decrease in blood sugar.
- "Bezafibrat". Similar to previous drug. It is prescribed to reduce the amount of cholesterol and lipoproteins in the blood.
Of the less toxic and more harmless drugs, Gemfibrozil and Fenofibrate are prescribed. These medicines have a fairly short list of side effects and contraindications.
A nicotinic acid
This remedy is also used to alleviate the symptoms of atherosclerosis of the legs and treat this ailment. These are the properties of nicotinic acid:
- Vasodilation
- Decreased LDL A daily dose reduces cholesterol by about 10% and triglycerides by as much as 28%.
- Normalization of blood pressure.
- Dissolution of blood clots formed in blood vessels.
Niacin is available in the form of ampoules with a solution for injection, tablets and powders. The dosage is determined by the doctor, but usually 3-5 grams per day is enough. Reception begins with a small amount (0.1 g three times a day), and then is brought to the maximum by adding 0.1 g per 5 times every 5 days.
Throughout the course of treatment of atherosclerosis of the vessels of the legs with nicotinic acid, the patient should be under medical supervision. Because this drug affects the liver and blood glucose, and therefore can lead to negative consequences.
Diet
In order to get rid of the symptoms of atherosclerosis of the vessels of the legs, and also to increase the effectiveness of drug treatment, it is necessary to observe proper nutrition. The purpose of the diet is to normalize metabolism, improve blood circulation and reduce weight.
Here are some things to exclude from your diet:
- Products from butter and puff pastry.
- Any fast food.
- Mushroom, fish and meat broths.
- Cooking Fats.
- Pork, duck, goose, brains, kidneys, liver.
- Smoked meats, canned food, sausages.
- Fish (fatty, smoked, salted) and caviar.
- Sour cream, cottage cheese, cream, cheese.
- Mushrooms, spinach, sorrel, radish, radish.
- Products with cream, ice cream, chocolate.
- Sauces and dressings.
- Cocoa, coffee, tea.
- Jam and honey.
- Sugar.
- Grapes and raisins.
- Egg yolks, semolina and rice groats.
- Pasta.
- Alcohol and smoking.
But what can be eaten with atherosclerosis of the legs:
- Green peas, potatoes, cabbage, pumpkin, zucchini, carrots, eggplant, beets, cucumbers, tomatoes.
- Greens.
- Vinaigrettes and salads seasoned with vegetable oil.
- Sea kale (daily).
- Low-fat ham, diet sausage, fresh cheese.
- Rye, grain, peeled, soy and wheat bread.
- Loose porridge from barley, millet, oat and buckwheat.
- Raw berries and fruits. You can make jellies and compotes from them.
- Dairy and tomato soups (on a weak vegetable broth).
- Wheat bran and rosehip broth (daily).
- Fresh garlic.
- Flax and fenugreek seeds.
Cooking is recommended steamed or by cooking. Some products can also be baked. But everything fatty, fried, harmful should be discarded.
Forecast
The outcome of atherosclerosis of the vessels of the legs depends on a number of factors. The severity of symptoms, heredity, the dynamics of the progression of the disease, age, and also the general state of health are important. Compliance with medical recommendations and competent treatment is also important.
It can be completely cured only if atherosclerosis of the limbs (legs) was detected in the first stage. And then, in a patient who has an uncomplicated history.
In this case, with the active treatment and assistance of the patient in the therapeutic process, the ailment will be taken under control. A person will avoid disability, prevent the development of complications, and also preserve limb functions.
Prevention
In order to never encounter this unpleasant disease, it is necessary to observe an appropriate lifestyle. Here are some preventative recommendations:
- It is necessary to give up smoking.
- To lead an active lifestyle, to ensure at least light physical activity.
- More often walking in the fresh air, swimming, gymnastics. This will help activate metabolism and burn excess calories before they turn into sclerotic plaques.
- Do not disrupt the medication schedule if a person has diabetes or hypertension.
- Maintain a balanced diet.
- Enrich your diet with vitamins, antioxidants, minerals, plant fibers and polyunsaturated fatty acids.
- Minimize the amount of sweets and fast food consumed.
And, of course, it is worth at least once a year to undergo a general examination. So you can either make sure of your good health, or at an early, asymptomatic stage to detect the disease and begin to treat it. This takes much less time, nerves and money, and also helps to avoid complications.