Obstructive pathology of the lower extremities

What is it?

It involves the formation of atherosclerotic plaques in the femoro-popliteal segment that cause a deficit of blood flow to the lower limbs, especially under stress.

It progressively forces people to walk with increasing difficulty until they suffer pain at rest, even at night, and develop ulcers and necrosis in the lower limbs.

The individuals most at risk are people who already have other atherosclerotic diseases (myocardial infarction, angina, stroke, etc..) and/or the following risk factors: smoking, diabetes, dyslipidemia (hypercholesterolemia, hypertriglyceridemia), hyperhomocysteinemia and some congenital diseases. Generally, men are more at risk than women and people over 50 years of age.

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).

Where do we treat it?

Within the San Donato Group, you can find Obstructive pathology of the lower extremities specialists at these departments:

Are you interested in receiving the treatment?

Contact us and we will take care of you.