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Ischemia is a lack of blood flow to certain areas of the lower extremities. It is often referred to as local anemia. The tissues in this case do not receive the required amount of oxygen and nutrients. This negatively affects the body: the legs get tired quickly, muscle pains appear. In the later stages, tissue necrosis is even possible. If the disease turned out to be running and gangrene has developed, drug treatment will be ineffective. An operation is required, during which the amputation of the limbs is carried out, otherwise the patient may die. The lowest parts of the legs are more susceptible to ischemia: feet and lower leg. They should be given special attention to prevent the development of the disease.
Causes of ischemia of the lower extremities
Atherosclerosis. It manifests itself in the form of plaque formation that clogs arterial vessels throughout the body. The course and severity of the disease depends on the lifestyle, heredity, the presence of bad habits. Atherosclerosis develops in older and older people. It does not necessarily lead to lower limb ischemia. Plaques can form in the vessels of the heart, which causes myocardial infarction, the brain, and then the likelihood of a stroke is high. As a result of circulatory disorders in the intestinal area, a “belly toad” is formed. The problems that atherosclerosis contributes to develop occur in areas where vascular occlusion is most pronounced.
Diabetes. The danger of ischemia arises not only in insulin-dependent patients, but also in patients with type 2 disease. Blood glucose levels do not have to be very high. Even a slight deviation from the norm can affect the vessels, contributing to the development of atherosclerosis, which in turn leads to ischemia.
arterial thrombosis. Thrombi form on the walls of blood vessels, which increase over time and gradually lead to complete blockage of the lumen. The reason for their appearance is a special type of atherosclerosis – obliterating. Under the influence of atherosclerotic plaques, a change in blood flow occurs. As a result, platelets stick together and accumulate on the walls of blood vessels.
Obliterating endarteritis. Unlike atherosclerosis, it is also characteristic of young people. The reasons for its appearance are bad habits, frostbite of the limbs, hypothermia, frequent intoxication of the body. Obliterating endarteritis progresses very quickly, affecting small vessels. In the later stages of the disease with tissue necrosis, the operation is already ineffective. Like atherosclerosis, endarteritis obliterans is one of the most common causes of lower limb ischemia. The ischemic stage is the mildest form of the course of the disease.
Degrees of ischemic disorder and their symptoms
In the process of development of ischemia of the lower extremities, several stages are distinguished:
At the first stage occlusion, that is, blockage of blood vessels, is very weakly expressed. The patient experiences a feeling of tingling, numbness in the legs. Often there is a feeling of goosebumps. The skin on the legs is pale, sweating is increased.
The second stage ischemia is characterized by functional circulatory failure. Symptoms of the disease appear during walking and the main one is intermittent claudication. Moving long distances requires frequent rest, as the muscles get tired quickly.
At the third stage circulatory failure worries the patient not only while walking, but also at rest. Pain is predominantly felt at night.
At the fourth stage ischemia of the lower extremities is the formation of ulcers on the fingers and feet. Such necrotic changes are a symptom that signals the need for immediate surgical intervention.
The use of painkillers for ischemia of the lower extremities is not only ineffective, but also dangerous. The disease develops rapidly, and then there is a threat of amputation of the legs. You can get rid of pain by bringing the limbs into a vertical position. For example, at night, lower your legs to the floor from the bed. In this case, venous blood accumulates in the tissues, squeezing the arteries and reducing arterial circulation. As a result, the formation of ulcers and tissue necrosis is even more active.
At the first symptoms of ischemia, you should consult a doctor. Patients who come to specialists in the later stages of the disease, in most cases, have to undergo surgery.
Diagnosis and treatment
To diagnose ischemia, an examination of the lower extremities is performed. The speed at which pain occurs during movement is important, so the doctor will likely ask the patient to actively bend and straighten the legs several times. With tissue compression, blanching of the skin occurs. This allows you to determine the site of the lesion.
During the diagnostics, methods are also used:
Electrothermometry,
capillarography and capillaroscopy,
arterial oscillography,
X-ray contrast aortoarteriography
They provide the maximum amount of information about the nature of the course of the disease and its stage. Based on the information received, the doctor prescribes treatment.
With ischemia of the lower extremities, it is strongly recommended to stop smoking. The ingestion of nicotine into the body stimulates the formation of plaques in the vessels. General therapy involves the implementation of special physical exercises that the doctor must prescribe.
Loads are effective only in the early stages of ischemia. The use of physiotherapy and drug treatment is aimed at improving blood circulation and its flow to the lower extremities. Surgical intervention is required in the later stages of the disease. It involves the removal of plaques from the arteries, the expansion of the lumen of blood vessels, prosthetics and shunting.