How is atherosclerotic occlusive disease of the lower extremities diagnosed and treated?

Lower extremity atherosclerotic occlusive disease (PAD) is caused by the formation of atherosclerotic plaques in the lower extremity arteries, resulting in narrowing and occlusion of the lower extremity arteries, which in turn leads to chronic ischemia of the limbs. With the improvement of the overall living standard of the society and the aging of the population, the incidence of lower limb atherosclerotic occlusive disease is increasing year by year. Epidemiological surveys show that smoking, diabetes, hyperlipidemia, hypertension, hyperhomocysteinemia, hypercoagulability, increased blood viscosity and advanced age are risk factors for lower limb atherosclerotic occlusive disease. Among them, smoking and diabetes are the most harmful, both of which can increase the incidence of peripheral arterial disease by three to four times, and the combined existence of the risk is even higher. Hyperlipidemia, especially elevated LDL cholesterol, is closely related to the development of atherosclerosis in many parts of the body. Timely detection and control of risk factors leading to atherosclerosis can slow down the process of atherosclerosis and reduce the risk of lower limb atherosclerotic occlusive disease. As the symptoms of early ischemia are not typical enough, patients must not self-diagnose and self-treat, which on one hand will delay the condition, and on the other hand the abuse of medication will also cause harm to the body. Patients should go to a vascular surgery specialist to confirm the diagnosis through scientific tests, such as non-invasive lower limb blood flow analyzer, lower limb arterial ultrasound, as well as CT, magnetic resonance imaging (MRI), etc., which can help to determine the presence of limb arterial stenosis and occlusion. If necessary, the doctor will advise the patient to undergo arteriography, which is currently the “gold standard” for the diagnosis of atherosclerotic occlusive disease of the lower extremities. Since blood does not show up under radiation, it is done by interventional means by first making a small incision at the root of the patient’s thigh, then feeding special materials (catheter, guide wire), injecting contrast medium that shows up under radiation into the blood vessel, and then displaying the blood vessel and its branches by using the imaging equipment, which can accurately display the location, degree and dynamic changes of blood flow of the intravascular lesion, and the status of the blockage of the distal outflow tract, which is called arteriography. Arteriography, a commonly used vascular examination method, the results of which have an important reference value for the choice of further treatment.