Atherosclerosis of the vessels of the lower extremities in adults

If the arteries in the legs are narrowed by more than 50% due to plaques on their walls, extremely unpleasant symptoms occur, problems with gait, which, if left untreated, can lead to disability.

What is atherosclerosis

Atherosclerosis is a serious disease associated with metabolic disorders, mainly fat metabolism, in which the ratio of “bad” to “good” cholesterol, as well as some other lipid components, changes. As a result, the walls of the arteries suffer, because of the plaques their internal lumen narrows, blood circulation and the delivery of oxygen and nutrients to the tissues are disturbed. This leads to serious disorders in the functioning of organs or tissues due to hypoxia, up to cell death (necrosis).

Causes of atherosclerosis of the vessels of the lower extremities in adults

The main causes of vascular damage in the lower extremities are a violation of fat metabolism, in which the walls are covered with a fatty coating, saturated with it, which causes their elasticity to suffer. Plaques also form in large arteries, which can narrow the lumen. Complement the problem formed in the walls of blood vessels connective tissue and calcium deposits. As a result, the arteries are severely damaged, less blood flows through them to the tissues of the foot, lower leg, knee, which leads to a disruption in the supply of nutrients and oxygen to the cells. If oxygen is critically low, the vessels are clogged with blood clots, even gangrene may develop.

The risk factors for atherosclerosis in the arteries of the legs are the same as for any other form of the disease. There are two groups:

• fatal – the patient’s age, unfavorable heredity, belonging to the male sex, the onset of menopause;
• removable – the presence of bad habits, overweight, metabolic disorders, inactivity, unhealthy diet, stress.

Symptoms appear if the lumen is narrowed by 50 – 75% or more. Most often, the lower part of the abdominal aorta is affected – in 33% of people, atherosclerosis affects the aorto-iliac segment, in 66% – the femoral-popliteal segment.

Symptoms of atherosclerosis of the vessels of the lower extremities in adults

Symptoms occur because the lower extremities receive less oxygen and nutrients, which disrupts the functioning of muscles and nerves. The most common signs of damage:

• intolerance to physical activity – legs get tired quickly even during normal walking;
• intermittent claudication – intense pain or burning in the legs after exercise, which requires a stop and rest;
• neuropathy – malnutrition of the nerves, which causes goosebumps, numbness of the legs or convulsive contractions;
• discoloration of the skin – pallor, dryness, constantly lowered temperature, especially in the foot;
• decrease in the amount of subcutaneous fat in the lower leg and thigh;
• muscle atrophy – one leg in volume can be much thinner than the other;
• disruption of the hair follicles – the hair becomes thin, sparse, falls out;
• the skin on the feet thickens, the nails become convex, cloudy, deformed.

The more affected the artery, the harder the changes will be. With a sharp narrowing of the vessel, severe pain can occur, malnutrition of tissues up to the development of gangrene.

Treatment of atherosclerosis of the vessels of the lower extremities in adults

This pathology occurs more often in men and in old age. Without timely treatment, changes in the legs will only intensify, which can eventually lead to disability, problems with walking, and in case of complications, loss of part of the limb due to gangrene.

Diagnostics

During the examination, the doctor first of all evaluates the pulse in the region of the arteries in the legs. This helps not only to identify the problem, but also the approximate localization of the plaque. He will also listen to the area of ​​​​the artery with a phonendoscope – damage to the walls of the vessel can be determined by the nature of the noise.

To clarify the diagnosis, the doctor will also conduct a series of tests and analyzes:

• will measure the ankle-brachial index (compare the pressure on the arms and legs – normally it is 1). If the score is below 0,7, the problem is serious;
• Do an ultrasound with Doppler to assess the state of blood flow in the arteries;
• prescribe radiopaque angiography to see defects in blood filling;
• conduct a biochemical blood test and a lipidogram, where changes in the level of plasma lipids will be visible;
• check the level of homocysteine ​​​​(high concentration increases the risk of illness).

Modern treatments

Treatment must be comprehensive. The doctor will definitely advise you to influence those risk factors that can be corrected – nutrition, bad habits, weight. In addition, a number of drugs are used to treat atherosclerosis:

• statins to lower harmful plasma lipids (Atorvastatin, Simvastatin, Rosuvastatin);
• preparations for correcting the level of homocysteine ​​- folic acid, vitamin B12;
• means for the normalization of coagulation and the prevention of blood clots (Aspirin-cardio, Cardiomagnyl, Clopidogrel, Ticlid, Cilostatol);
• vasodilators (Pentoxifylline);
• antispasmodics (papaverine, No-shpa, Drotaverine);
• prostaglandin analogues (Vazaprostan).

To eliminate pain, the doctor may recommend local non-steroidal anti-inflammatory drugs – Diclofenac gel, Nimid gel, Dolobene gel, Voltaren gel.

In advanced cases, surgical treatment is necessary. Depending on the age, general condition, localization of the lesion, the methods that will be most effective are selected – these are stenting and balloon angioplasty, shunting of the affected artery, removal of blood clots from the artery, partial removal of the affected artery with replacement with a prosthesis. If gangrene has developed, amputation of the limb is indicated.

Prevention of atherosclerosis of the vessels of the lower extremities in adults at home

Prevention of atherosclerosis is a healthy lifestyle. Move more often and more, reduce fatty and sugary foods, alcohol in the diet, stop smoking, gradually reduce body weight, walk more often.

It is equally important that you regularly visit a doctor, undergo medical examinations and correct any changes in your health.

Popular questions and answers

We talked with cardiologist Tamaz Gagloshvili.