Obstructive pathology of the lower extremities
Which are the symptoms?
It is initially asymptomatic, but later appears a cramp-like pain in the calf sometimes associated with pain in the thigh and buttock. This pain is typically intermittent (claudication intermittens) in relation to walking and exertion and may be associated with paresthesias (skin tingling). As the disease progresses, pain occurs even at rest, may prevent night rest, may occur hypothermia and cyanosis of the limbs (cold and blue fingers) until the appearance of peripheral ulcers and distal gangrene.
- Cramping pain at the level of the calf
- Pain at the level of the thigh and gluteus
- Hypothermia and cyanosis of the limbs
- Claudication intermittens
- Peripheral ulcers
- Distal Gangrene
How is it diagnosed?
Patients with the described symptoms are at high risk for suspicion of steno-obstructive pathology of the lower extremities and should undergo diagnostic imaging tests.
How is it treated?
Medical treatment: therapy with antiplatelet agents that prevent platelets from binding to atherosclerotic plaques, aggravating the disease; hemodial drugs making the blood smoother and able to flow more easily within the affected vessels; vasodilators that increase peripheral vascularization. The correction of the risk factors of individual patients, abstention from smoking and proper physical activity is essential. Results can be good in the early stages of the disease.
Surgical treatment: it is implemented by replacing (bypass) the occluded artery with a synthetic or biological prosthesis (saphenous vein). In some cases it is possible to clean the arteries only (endoarterectomy), removing the atherosclerotic plaques from the inside.
Endovascular treatment: feasible only in cases of segmental stenosis and not occlusion. Percutaneously (without incisions) an arteriography is carried out and the arteries are dilated at the points where they are stenotic (narrowed), possibly implanting one or more stents (small tubes of metal mesh).