Obliterating atherosclerosis among other diseases of peripheral vessels occupies a leading position.
Most often the disease affects men over fortyyears. Obliterating atherosclerosis often causes severe ischemia, dooming patients to very painful suffering. At the same time, many patients are unable to work. Primarily noted obliterating atherosclerosis of the arteries of the lower extremities. The process can be localized in the aorta. In addition, often the disease affects the mid-caliber arteries - the femoral and popliteal.
Obliterating atherosclerosis of the vessels of the lower extremities is associated with the same etiological factors and pathogenetic mechanisms that provoke the disease of other localization.
Major changes are noted in the circumference of the focilipoidosis. There is a fresh connective tissue. Ripening, it leads to an increase in fibrous plaque. In these formations, clots of fibrin and platelets settle. Abundant lipid accumulation provokes a blood circulation disorder in the plaques. Their necrosis causes, in turn, the formation of an athere. Contained in their cavities atheromatous masses fall into the lumen of the vessel. Tearing in the distal direction, they can provoke embolism.
Along with this, in the affected tissuesplaques, in the areas of elastic fibers, experiencing degeneration, calcium salts begin to be deposited. Thus obliterating atherosclerosis passes in the last stage.
Throughout the disease there are four stages.
Obliterating atherosclerosis for several years can develop without any manifestations. However, since the appearance of the first clinical symptoms, it often very quickly progresses.
In some cases, due to thethrombosis, manifestations of ailment are characterized by suddenness. In the anamnesis often in patients with hypertensive disease, heart attacks, angina attacks, diabetes mellitus, cerebral circulatory disorders.
Symptoms of the disease should be attributedintermittent claudication, which is manifested by painful gastrocnemius muscles. Sensations, as a rule, arise during walking and pass after a short rest.
Atherosclerotic lesions of the iliac arteriesand the terminal area of the abdominal aorta provoke the localization of pain not only in the region of the legs, but also the buttock femoral muscles, as well as in the lumbar region. Strengthening of intermittent claudication is noted when climbing a mountain or a ladder.
Typical manifestations are feelingchilliness, increased sensitivity of the feet to cold, numbness of the feet. As a result of ischemia, the color of the skin of the lower limbs changes. At the beginning of the development of the disease they acquire a pale color. With the course of the disease, the skin of the fingers and feet becomes purple-cyanotic.
Trophic disorders disrupt the growth of nails, contribute to hair loss.
Progression of the disease is characterized byulcerative-necrotic changes in the soft tissues of the distal zones of the affected limbs. This marked swelling and hyperemia of the feet. With occlusion of the aortic iliac region, a characteristic symptom is impotence caused by a disorder in the circulation.
Inspection of patients often reveals atrophy or malnutrition of the muscles in the lower limbs.
Often there is a lesion of the femoral-popliteal segment, which is expressed in the absence of pulsation either on the arteries of the feet or on the popliteal artery from the site of the deep thigh artery.
The main method of diagnosis isangiography. This method allows to reveal the extent and localization of the pathological process, the level of vascular lesions, to characterize the collateral circulation, and also to assess the state of the distal blood flow channel.