I. What is lower extremity atherosclerosis occlusive disease?
Lower extremity atherosclerosis occlusive disease refers to the formation of atherosclerotic plaque on the inner wall of arteries, proliferating and protruding into the blood vessels. As the plaque continues to expand and secondary thrombosis forms, the blood vessels become narrow, the blood flow slows down and the blood flow decreases, and when the narrowing reaches a certain level and even forms lumen occlusion, the blood flow supplied to the lower extremity cannot meet the needs of the body, and chronic or acute ischemic symptoms occur in the lower extremity.
Second, the current incidence of lower extremity atherosclerosis occlusive disease?
In China, with the improvement of people’s living standard, the change of diet structure, and the aging of the population, the number of cases diagnosed as lower extremity atherosclerosis occlusive disease has been increasing year by year. According to the literature, the incidence rate is as high as 17% among people aged 55-70 years.
What are the main manifestations of lower extremity arteriosclerosis occlusive disease?
1, in the early stage of lower limb atherosclerosis occlusive disease, the patient will generally feel the lower limbs often cold, numb, leg muscles will appear spasm, commonly known as cramps, because these early lesions are not typical, it is easy to confuse with other diseases, so often the patient is mistaken for the elderly calcium deficiency or lumbar disc prolapse, and then misdiagnosed and mistreated, delaying their own condition. Therefore, patients who have these symptoms should be reminded to go to a regular hospital to confirm the diagnosis through scientific examination.
2, pain after exercise: medically known as intermittent claudication, is the most common symptom of lower extremity atherosclerosis occlusive disease, performance is the patient walking a distance, spastic pain, forced to stop exercise, rest for a while, pain relief, again after exercise, pain recurring. With the aggravation of ischemia, the distance that the patient has pain after walking will become shorter and shorter, from several hundred meters to finally a dozen meters or even a few meters.
3. Pain at rest: Medically known as resting pain, it is a manifestation of severe ischemia in the limbs, that is, the patient will still have insufficient blood supply to the muscles and other tissues when not exercising, and pain will appear, especially at night when the patient is sleeping. The pain is aggravated by raising the lower limb and can be relieved by low hanging or light activity, making it difficult for the patient to sleep and eat and nervous. This period suggests that the patient must be actively treated, otherwise further development will enter the necrotic phase.
4.Tissue ischemia and hypoxia eventually lead to necrosis: In this period, the patient’s artery is severely occluded and the collateral circulation is poor, or complicated by arterial thrombosis. When the symptoms of necrosis are mild, the limbs will have tissue nutrient disorders, rough, flaky or cracked skin; scanty or lost sweat hair; slow growth of toenails, thickening, less luster, and very difficult to heal after the break on the foot. When the symptoms of necrosis are aggravated, the lower limbs appear necrosis, and those with co-infection can have the manifestation of systemic poisoning, even life-threatening, and some patients eventually face amputation.
Fourth, what are the diseases that can be easily misdiagnosed with lower limb atherosclerotic occlusive disease?
1.Lumbar disc prolapse.
There is typical sciatica, that is, radiating pain from the lumbar region to the hip, the back of the thigh, the outer calf until the foot.
2. Age-related osteoporosis.
Mostly caused by the massive loss of bone calcium in old age without timely replenishment. It is manifested as limb pain, but the skin color and temperature of the painful limb are normal, and the peripheral arterial pulsation can also be palpated, but the patient is highly susceptible to fracture. Many elderly patients with atherosclerosis are often misdiagnosed with this disease, and calcium supplementation treatment is ineffective and the condition worsens. Therefore, elderly people with limb pain without obvious causes should undergo vascular examination to avoid misdiagnosis.
V. What are the treatments for lower extremity atherosclerosis occlusive disease?
The treatment of lower extremity atherosclerosis occlusive disease should be selected according to the patient’s condition. The main ones are.
1.Improve lifestyle habits: actively treat primary diseases such as hypertension and diabetes. Consume more low-salt, low-sugar, high-fiber and plant foods containing unsaturated fatty acids, such as beans, fruits, vegetables, etc. Quit smoking: smokers are 9 times more likely to have intermittent claudication than non-smokers, and almost 90% of patients with intermittent claudication are smokers; therefore, quitting smoking is an effective measure to reduce the incidence.
2, physical therapy: patients should have moderate physical exercise, such as walking, jogging is very good, which can relax the spirit and relieve tension; through physical therapy, manipulation massage to make the skin temperature is also a better complementary therapy, whether exercise or physical therapy, the important thing is that they all help the establishment of collateral circulation and improve ischemia.
3.Lipid-lowering drugs, antihypertensive drugs, vasodilators, antiplatelet drugs and anticoagulant drugs can be applied under the guidance of vascular surgeons. If there is arterial thrombosis, thrombolytic drugs can be used. The main role of the currently applied drugs is to control the continued development of the disease, improve the collateral circulation of the affected limb, relieve pain and promote ulcer healing.
4, surgery: for intermittent claudication gradually aggravated, affecting work and even life can not take care of themselves, or due to limb ischemia caused by resting pain, tissue necrosis patients, surgical treatment (such as arterial bypass surgery, the people called “bypass surgery”), these patients if not timely surgery, eventually inevitable amputation. In patients with localized gangrene, postoperative healing of the wound can be promoted. Patients treated surgically must be given imaging data to fully evaluate the status of the vessels before determining the surgical plan.
5. Endoluminal treatment: If CTA (CT angiography), MRA (magnetic resonance angiography) or DSA (digital silhouette angiography) imaging results show that the arterial stenosis or occlusion is segmental, and there are more normal arteries proximal and distal to the stenosis or occlusion, endoluminal treatment, such as balloon dilation and stent placement, can be performed. These methods are less invasive, faster recovery, and do not require conventional anesthesia and surgical incision, but the cost is relatively high.
How to prevent lower limb atherosclerosis?
1, to stop smoking and limit alcohol; low-fat and low-sugar light diet, eat more fresh vegetables, fruits and other vitamin-rich food; regular and moderate living.
2, appropriate fitness exercise, avoid obesity: regular exercise is equal to let the blood vessels do gymnastics, can enhance the elasticity and prevent aging.
3, good at adjusting their emotions, to avoid long-term depression and tension.
4, several foods to prevent atherosclerosis: milk, soybeans, ginger, garlic, onions, fungus, oats, sweet potatoes, hawthorn, tea, sea fish, honey oranges, can reduce the content of cholesterol and triglycerides in the blood.
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