Overview
Atherosclerotic stenosis of the abdominal arteries is the main cause of stenosis of the abdominal arteries. The abdominal arteries are the main means of blood supply to the abdominal organs and ensure the function of the major organs, and atherosclerotic stenosis of the abdominal arteries is the main cause of ischemia in the abdominal organs.
Etiology
1. High blood pressure
Long-term impact of high-pressure blood flow on the arterial wall causes mechanical damage to the arterial lining, resulting in easy deposition of lipids in the arterial wall, forming fatty plaques and causing atherosclerotic stenosis.
2. Hyperlipidemia
Excessive fat in the blood is easily deposited in the inner wall of blood vessels to form plaques, causing atherosclerosis and stenosis. A large intake of fatty foods and cholesterol-rich foods is the main cause of atherosclerosis.
3. Diabetes
Diabetic patients have problems with fat metabolism, and the proteins (called lipoproteins) that transport fat in the blood are denatured, making it easy for fat to be deposited on the inner walls of blood vessels to form fatty plaques during the transportation process.
4. Smoking
Nicotine and carbon monoxide in cigarettes can damage the inner wall of the arteries, and the injured arterial wall can trap cholesterol, causing platelets to accumulate and form fatty plaques. At the same time, smoking can also cause coronary artery contraction and spasm, reducing blood flow.
5. Family history
This refers to genetic factors that cause atherosclerotic disease to occur in some people at an early age, the cause of which is still unknown. Some people have severe hypercholesterolemia, which iteratively accumulates in the blood and thus contributes to the development of atherosclerosis.
6. Other
Lack of exercise, obesity or overweight people, excessive stress and other causes can also aggravate or lead to atherosclerosis of the abdominal arteries resulting in atherosclerotic stenosis of the abdominal arteries.
Symptoms
As the abdominal artery is the main way of blood supply to the abdominal organs, so the abdominal arteriosclerotic stenosis will lead to ischemia of the corresponding abdominal organs, but the disease is insidious, not easy to be found, mostly found in the physical examination, the early stage can be asymptomatic, with the degree of stenosis of the abdominal artery aggravated by the corresponding ischemia of abdominal organs, hypoxia aggravated, which leads to corresponding symptoms, such as abdominal pain, diarrhea, etc., or even ischemic necrosis, which leads to organ function. Even ischemic necrosis occurs, leading to loss of organ function and organ failure, which can be life-threatening in severe cases.
Examination
1. Ultrasound of abdomen
It can show the shape and size of abdominal organs and whether they are symmetrical.
2. Spiral CT and magnetic resonance angiography
It can determine whether the abdominal blood vessels have stenosis, as well as the condition of stenosis and the degree of stenosis.
3. Abdominal Angiography
It is a very effective way to evaluate the stenosis of abdominal blood vessels.
4. Selective abdominal arteriography
This refers to the insertion of a catheter into the abdominal artery through catheterization techniques, followed by injection of a contrast medium into the abdominal artery to show the blood flow, and X-ray fluoroscopy or imaging to determine the site of obstruction or stenosis.
Diagnosis
If risk factors for atherosclerosis are present, along with symptoms such as postprandial abdominal pain and lethargy, atherosclerotic stenosis of the abdominal arteries may be considered after other causes have been ruled out. In a few patients, a vascular murmur can be heard in the epigastrium, and imaging studies can be helpful in diagnosing abdominal atherosclerotic stenosis.
Treatment
The treatment of abdominal atherosclerotic stenosis should aim at prolonging survival and improving the quality of life. It mainly includes conservative treatment and surgery.
1. Conservative treatment
(1) Improvement of poor lifestyle, mainly low-salt and low-fat diet, reduction of calorie intake, exercise, weight control, and keeping a happy mood.
(2) Drug therapy: mainly for the treatment of the cause, such as the control of hypertension, diabetes, hyperlipidemia and other underlying diseases, to reduce and prevent the progression of systemic atherosclerosis and abdominal atherosclerotic stenosis.
2.Surgical treatment
Surgery has good efficacy in controlling the symptoms of abdominal artery stenosis and slowing down and reversing the course of the disease, most patients’ symptoms can be controlled and improved, and only a small portion of patients’ conditions continue to progress. However, surgical treatment has the disadvantages of large trauma, abdominal artery stenosis patients often combined with cardiovascular and cerebrovascular atherosclerosis, surgery is not suitable for patients and their families to accept and so on. With the continued development of medicine, long-term chronic abdominal pain, the systematic examination to exclude the common causes of the disease, while there is clear evidence of abdominal artery stenosis in the imaging examination of patients can be interventional therapy, is currently an effective treatment program.
Prognosis
Most patients with abdominal arteriosclerotic stenosis may have a combination of carotid arteriosclerotic stenosis, renal arteriosclerotic stenosis, and cardiovascular arteriosclerotic stenosis, which may eventually be associated with renal failure, coronary artery disease, and stroke. Therefore, early detection and treatment are important ways to improve the prognosis of the disease.
Prevention
It is mainly aimed at the prevention of the causes of the disease, such as actively controlling hypertension, diabetes mellitus, hyperlipidemia and other underlying diseases; and having good living habits such as low-salt and low-fat diet, eating a balanced diet, quitting smoking, restricting alcohol, and keeping a happy mood; at the same time, attention should be paid to physical examination, in order to detect the degree of abdominal arterial atherosclerosis and stenosis in a timely manner, in order to facilitate the early treatment, and to improve the quality of life.