Angiopathies are a group of pathologies associated with damage to the vascular structures and poor circulation. The development of the disease occurs gradually: arteries and veins lose their tone, the gaps inside them narrow. As a result, organs are malnourished. Angiopathy of the lower extremities is diagnosed mainly in patients with diabetes mellitus. Lack of adequate therapy can lead to amputation and even death. In order to avoid such complications, you need to know what symptoms accompany the pathology and when to consult a doctor.
Is angiopathy a symptom or a disease?
Almost all blood vessels in the human body can be subject to pathological changes. Of particular interest is the defeat of the microcirculatory structure, which is represented by many plexuses. Speaking of angiopathy, most often refer to the pathology of the lower extremities. Even absolutely healthy people have to face such a diagnosis. Why is this happening? This phenomenon can be explained by the lack of mutual understanding between different specialists and overly impressionable patients. The latter, having heard an unknown diagnosis, immediately panic.
It must be clearly understood that the described deviations cannot be an independent disease. Angiopathy is a manifestation or complication of certain functional disorders in the body. In its essence lies a decrease in elasticity and a decrease in the lumen of blood vessels. As a result, symptoms of circulatory disorders in the tissues appear. This clinical picture is characteristic of damage to the muscle layer of the vascular wall or changes in its innervation. In this case, a spasm occurs while slowing down the speed of blood flow.
The main causes of angiopathy
Doctors distinguish a number of factors that contribute to the emergence of a pathological process. Among them, diabetes comes first. Angiopathy of the lower extremities in 70% of cases develops against the background of an excess of blood sugar. 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 become covered with fat, the blood becomes thicker. Together, these factors provoke the development of angiopathy.
Other causes of the pathological process include:
- smoking;
- work with toxic materials;
- hypotension;
- congenital disorders in the circulatory system;
- hereditary predisposition.
The treatment of angiopathy depends on the timeliness of the diagnosis. That is why it is important to be able to recognize the symptoms of the disease at an early stage.
What forms does angiopathy of the lower extremities have?
ICD-10 (International Classification of Diseases) assigned this pathology code 179.2. In its course, it is customary to distinguish two forms:
- Microangiopathy (damage to small vascular formations). Often combined with retinal dysfunction, impaired renal blood flow.
- Macroangiopathy (damage to arterial structures of medium and large caliber). This violation is characteristic only of the vessels of the limbs.
Each form of the pathological process has a specific clinical picture.
Symptoms of microangiopathy
At the initial stage, microangiopathy of the lower extremities practically does not manifest itself. However, when examining blood vessels, certain changes are already detected in them, which over time begin to cause discomfort. The skin becomes pale and cold to the touch. Small sores appear on the legs, which spread very quickly to new areas. The patient may be disturbed by discomfort, pain after physical exertion. Around ulcers, the skin acquires a reddish tint, puffiness. The penetration of the pathological process into muscle or bone tissue is accompanied by the appearance of phlegmon. Necrotic areas gradually go beyond ulcers, spreading to the fingers. If the entire foot is affected, the only option to save the leg is to amputate 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 the discomfort does not disappear throughout the day and is supplemented by numbness in the fingers. The legs are constantly freezing, sometimes alternating claudication is observed . The skin becomes pale. Intermittent claudication becomes more pronounced day by day. To all the symptoms are added severe pain in the legs, cramps. Unpleasant sensations (burning, tingling) do not leave the patient even during rest. Later, swelling and sores with signs of necrosis appear. More and more new sites are gradually involved in the pathological process. Macroangiopathy of the lower extremities is often accompanied by fever, general weakness.
What is the danger of angiopathy in diabetes?
Pathological changes in the vessels of the limbs are a frequent companion of patients with diabetes. Atrophy and circulatory disorders in the foot are a consequence of the loss of capillary capacity. Excess sugar in the blood gradually destroys the walls of blood vessels. In some parts they become thinner, in others they thicken. As a result, the lumen of the vessels narrows, and the tissues die against the background of oxygen starvation. As the disease develops, the fingers atrophy first, then the entire foot, lower leg and thigh. Affected structures require immediate amputation, since gangrenous processes occur in them. In this case, pulsation in the extremities is often observed.
Diabetic angiopathy of the lower extremities is the most serious complication faced by patients with insulin deficiency in the blood. Its prevention is recommended immediately after the diagnosis is confirmed.
Modern diagnostic methods
If lower extremity angiopathy is suspected, the first step in the diagnosis is to collect the patient’s history and examine the affected areas. After that, they move on to laboratory research using high-tech devices:
- MRI Allows you to evaluate the structure of soft tissues.
- Ultrasound Doppler study helps determine the state of the walls of the vessels, and duplex scanning - the speed of blood flow.
- Angiography. X-ray diagnostics using a contrast agent allows you to visualize vascular patency.
- CT Used to study pathological areas of the limbs.
The use of these diagnostic methods is necessary to obtain a general picture of the pathological process, assess the degree of vascular damage. Examination of the patient also allows you to determine what form the angiopathy of the lower extremities belongs to.
Treatment: drug and surgical
The methods of treatment for angiopathy depend on the reasons that provoked its appearance. In the early stages, sometimes even a simple adjustment of nutrition and lifestyle leads to a slowdown of the pathological process. What other treatment options are there?
- Drug therapy. Patients with a diagnosis of angiopathy of the lower extremities are prescribed drugs to improve vascular tone and normalize blood pressure. It is also recommended to take medications that stimulate the blood circulation processes (Actovegin, Eskuzan, Heparin). All drugs are selected individually, taking into account the overall clinical picture of the disease.
- Lymphomodulation. Carrying out special procedures helps to improve blood and lymph circulation in the body, the rapid excretion of metabolic products. After several treatment sessions, swelling of the skin in the affected areas is noticeably reduced.
- Operation. Surgery involves tissue repair and 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 poisoning is fatal.
Treatment with folk remedies
Traditional healers offer their own recipes 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 treatment with folk remedies must be combined with traditional methods.
Healers suggest using plants that help normalize metabolism in treatment. This is ginseng, Aralia Manchurian, safflower Leuzeus and others. From these plants you can prepare decoctions and tinctures. To improve carbohydrate metabolism, doctors recommend adding leaves of medicinal dandelion and elecampane to tea. Coffee is better to replace with chicory. It must be dried, fry and grind. The leaves of the plant can be used for dressing salads.
Treatment of angiopathy in diabetes
Earlier, we talked about the symptoms that accompany angiopathy of the lower extremities. With diabetes, treatment is practically no different from that in the case of other causes of the pathological process. The basis of drug therapy are drugs that improve blood coagulation. Glucose values are regulated through the administration of insulin. An additional therapeutic effect is given by physiotherapy. For example, mud treatment and plasmapheresis can cleanse the blood.
In advanced cases, resort to surgical intervention. At the initial stage of the development of pathology, lumbar sympathectomy is used. Reconstructive operations also give a positive effect , thanks to which it is possible to normalize microcirculation. Running angiopathy of the arteries of the lower extremities, accompanied by gangrene, requires amputation. After a rehabilitation course, a high-quality prosthesis is made to the patient.
Preventive measures
In diabetes or hypertension, the prevention of angiopathy must begin immediately after confirming the diagnosis. To do this, it is recommended to 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 extremities requires immediate treatment when the first symptoms of the disease appear. The course of therapy should be prescribed by a doctor.
In addition, the prevention of pathological changes in blood vessels includes the following measures:
- quitting smoking and other addictions;
- practicing active sports;
- strengthening immunity and central nervous system;
- balanced diet;
- fight against overweight.
The most important thing is a positive attitude. It is he who, as a rule, has a decisive influence on the healing process.