Lower limb obliterative arteriopathy (AOMI) is defined by a narrowing of the caliber of the arteries in the lower limbs, resulting in both painful and cardiovascular symptoms.

Arteriopathy obliterating of the lower limbs (PAD) is characterized by a reduction in the diameter of the arteries supplying the lower limbs: hips, legs, feet, etc.

The main arteries that provide blood to this part of the body are: the iliac artery (in the pelvis), the femoral artery (in the femur) and the tibial artery (in the tibia). They are also the arteries most widely involved in the disease.

The narrowing of the caliber of these arteries is the consequence of the formation of atheroma plaques: cellular debris, and accumulation of cholesterol.

Obliterating arterial disease of the lower limbs is usually non-symptomatic at first. The patient is even unaware that he has it.

The decrease in arterial diameter induces a drop in systolic pressure (blood pressure circulating in the body, during the contraction of the heart), in the lower limbs.

Two forms of ischemia (decrease in arterial vascularization) can then be differentiated:

• exertional ischemia, which may or may not present ischemic symptoms
• permanent ischemia, the clinical signs of which are more often visible.

Epidemiologically, this pathology affects nearly 1,5% of French individuals under the age of 50. But also more than 5% of people over 50 and 20% of over 60.

Men are said to have an increased risk of developing this type of arterial disease, with a ratio of 3 male cases to 1 female case.

Looking for a medical history, as well as seeing specific symptoms, are the first steps in diagnosing this condition. Clinical examinations follow: measurement of the pulse, or the systolic pressure index (IPS). This second step allows in particular to have a vision on the stadium of the AOMI.

The root causes of the disease are:

• un diabetes
• a obesity or overweight
• hypercholesterolemia
• a hypertension
• smoking
• physical inactivity

Each individual can be concerned by the development of such a pathology. Nevertheless, a predominance is to be associated with people over 50 as well as with men.

The general symptoms of the disease are:

• muscle pain in the lower limbs, especially in the legs
• the onset of repeated cramps, also called intermittent claudication
• skin changes, temperature change in the lower limbs can also be significant clinical signs.

These symptoms are amplified in the context of more or less exposure to the cold.

Certain risk factors exist when the development of this type of arteritis. In particular underlying cardiovascular damage, or the advanced age of the individual.

The first phases of the diagnosis of arteritis obliterans of the lower limbs result from observations and clinical examinations: visible clinical symptoms and signs, measurement of the systolic pressure index, measurement of the pulse, etc.

Other complementary examinations can support these first phases: Doppler ultrasound of the lower limbs, a standardized walking test, an ultrasound of the aorta, an electrocardiogram, or even an in-depth cardiological and lipid assessment.

The prevention of this disease is primarily based on changes in the patient’s lifestyle:

• smoking cessation, if the latter is a smoker
• practice of a regular and adapted physical activity. Walking, for example, can be highly recommended
• regular weight control
• adoption of a healthy and balanced diet.