Causes of “rotten leg”
The arteries of the body are the channels that carry blood from the heart to all parts of the body. Due to the formation of lipid deposits and plaque in the artery walls, the lumen of the artery can be narrowed or even blocked, a process called atherosclerosis occlusion, which leads to arterial ischemia. When the human leg muscles do not have sufficient blood supply, the legs can feel weak, sore and painful when moving, which is called arterial ischemia of the lower extremities and is medically known as “lower extremity arterial occlusive disease”. Sometimes, the surface of the plaque on the arterial wall may rupture and cause thrombosis. When the thrombus is dislodged and flows with the blood, it can block the small blood vessels at the distal end, resulting in sudden pain, numbness and other acute ischemic symptoms in the legs. If the artery is “blocked” for a long time, it can cause serious ischemia of the toes and leg muscles, and skin ulceration, which leads to the occurrence of “old rotten leg”.
Symptoms of the disease
The disease usually has the following symptoms: intermittent claudication after walking for a certain distance, because the blood supply to the lower extremities is reduced and cannot satisfy the active limbs. After walking intermittently for a certain distance, the blood supply to the lower extremities is reduced, and the high blood flow required for the movement of the extremities is not met. If the above symptoms are repeated after walking again. Rest pain arterial lesions are severe, the limb is severely ischemic, the lower limb arterial blood supply cannot meet the needs of the, leg, so even at rest, the limb still has pain. Tissue necrosis The arterial ischemia of the lower limbs continues to worsen, and the tissues of the legs and feet become nutritionally impaired, with skin ulceration and tissue necrosis occurring.
Risk factors for lower limb atherosclerosis occlusive disease
Correctable
1, hypertension.
2, smoking.
3, hyperlipidemia.
4, obesity.
5, Sedentary lifestyle.
Uncorrectable
1, age and sex.
2, diabetes mellitus (DM), 30-50% of diabetic patients also suffer from lower extremity arterial disease, and the amputation rate is 4 times higher in non-diabetic patients.
3. family history.
Diagnostic methods
Checking the pulsation of the arteries in the foot
1, ratio of ankle artery pressure to upper extremity artery pressure.
2. vascular ultrasonography.
3.Vascular CT and MR (magnetic resonance imaging) examinations.
4. angiography.
Treatment of “old rotten leg” – revascularization
There are two ways to reconstruct the arteries of the lower limbs to increase the blood supply to the lower limbs.
1.Lower limb artery “bypass” surgery, under general or semi-body anesthesia, using its own saphenous vein or artificial blood vessels, across the occluded stenotic vessels, to direct the blood from the proximal end of the “blocked lesion” to the distal end of the lesion.
2.Endovascular treatment. When the patient is awake, through local anesthesia, a thin and soft balloon catheter is inserted into the lower limb through the root of the thigh or the artery on the arm and placed at the stenotic lesion, and slowly pressurized by the pressure pump, the balloon on the catheter expands and expands, squeezing the plaque in the lumen against the wall of the artery. To prevent restenosis of the dilated arterial lumen, in some cases, a stent is placed in the vessel to fix the plaque to the arterial wall, thus maintaining long-term patency of the arterial lumen. The advantages of endoluminal intervention are less trauma, faster recovery, shorter hospital stay and fewer complications, and it has an immediate therapeutic effect. Except for iodine allergy and extremely critical patients, almost all patients with “old rotten leg” can be suitable for endovascular treatment. After successful treatment, blood flow is restored to the diseased lower extremity and the soreness disappears, and when combined with local debridement treatment, “old rotten leg” can be cured. Since the end of 2006, the Department of Vascular Surgery of Renji Hospital has been the first in China to carry out the treatment of arterial occlusive lesions in multiple segments of the lower extremities, and has accumulated thousands of cases of treatment experience so far, so that countless “old rotten legs” and “vasculitis” have escaped “a The success rate of treatment has reached over 90%.