What is Lower Extremity Arterial Disease?#
Lower extremity arterial disease is the narrowing or complete blockage of arteries carrying clean blood to the legs due to atherosclerosis (hardening of the arteries). Cholesterol, fat, and calcium layers (plaque) accumulating in the vessel wall obstruct blood flow and impair the nutrition of leg muscles.
Commonly Affected Vessels:
- Aortoiliac segment (Abdomen and groin vessels)
- Femoral arteries (Thigh vessels)
- Popliteal artery (Vessel behind the knee)
- Tibial arteries (Vessels below the knee)
Causes and Risk Factors#
The most important factors leading to vascular blockage are:
- Smoking (Biggest risk factor)
- Diabetes
- Hypertension (High blood pressure)
- High cholesterol (Hyperlipidemia)
- Advanced age
- Obesity and sedentary lifestyle
What are the Symptoms?#
The disease can progress silently. The most typical symptom is walking pain called claudication.
1. Claudication (Intermittent Limping)#
- Cramp-like pain starts in the calf, thigh, or buttocks after walking a certain distance.
- The pain resolves within 1-2 minutes when the patient stops and rests.
- Pain recurs at the same distance when walking starts again (“Window Shopper’s Disease”).
2. Critical Limb Ischemia (Advanced Stage)#
As the disease progresses, vessels become more severely blocked and symptoms worsen:
- Rest Pain: Severe pain in the leg or foot while lying down at night; the patient tries to relieve relief by hanging the leg down from the bed.
- Foot Wounds: Spontaneous and non-healing wounds on toes or heel.
- Gangrene: Discoloration and blackening (tissue death) in toes.
Diagnostic Methods#
- Physical Examination: Pulse check in legs.
- ABI (Ankle-Brachial Index): Comparison of arm and ankle blood pressures.
- Doppler Ultrasonography: Visualization of blood flow with sound waves.
- CT Angiography: Used for detailed mapping of vessels.
Treatment Methods#
The goal of treatment is to increase walking distance, relieve pain, and prevent limb loss.
1. Lifestyle and Medical Treatment#
Basic treatment in early stages and for all patients:
- Strict cessation of smoking.
- Regular walking exercises (Develops collateral vessel network).
- Blood thinners and cholesterol-lowering drugs.
- Diabetes and blood pressure control.
2. Endovascular (Non-Surgical) Treatment#
Today, most patients can be treated with angiographic methods without incision or general anesthesia. The procedure is performed through the groin with local anesthesia.
- Balloon Angioplasty: Special balloons are inflated in the narrowed area to widen the vessel.
- Stenting: A metal mesh (stent) is placed if the balloon is insufficient or to prevent re-narrowing.
- Drug-Coated Balloon/Stent: Drug-eluting technologies are used to minimize the risk of re-occlusion.
- Atherectomy (Shaving): Calcified plaques inside the vessel are shaved and cleared with special devices.
3. Surgical Treatment#
In very long or complete blockages where endovascular method is not suitable, Bypass surgery (bridging with an artificial vessel or patient’s own vein) may be required.
Frequently Asked Questions#
Why does leg pain occur while walking?
Can peripheral artery disease be treated?
Does walking distance increase after stenting?
What is critical limb ischemia?
Should smoking be stopped?
If you experience leg pain while walking or have non-healing wounds on your feet, contact us for early diagnosis and treatment.
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