What is arteriosclerosis?
Here is a simplified explanation: Arteries are constructed of a three layered wall. The inner layer or endothel lines the inner vessel tube. The medial wall or media consists of muscle cells which tighten the vessel walls and regulate it`s diameter. The outer layer, called “adven-titia”, connects the vessel with the surrounding tissue.
Arteriosclerosis is caused by a complex metabolism imbalance of the arterial wall which is being promoted by different general illnesses, i. e. high blood pressure, diabetes, lipid me-tabolism and nicotine. As a result, the vascular walls become hardened and clotted, leading to build-up of arteriosclerotic plaque which in turn can restrict or block the vessel lumen. Suf-ficient blood supply in this area is therefore no longer warranted. Arteriosclerosis can affect all arteries in the body. Most commonly affected are the coronary vessels (heart attack), the brain vessels (stroke) as well as the pelvis- and leg vessels (peripheral artery occlusive dis-ease).
Does the patient feel any pain or discomfort?
If the pelvis- and leg vessels are involved, cool and pale skin along the legs could indicate peripheral artery occlusive disease. The patient feels pain only after the illness has already advanced, when the artery volume has been constricted by more than 50%. If pain forces one to rest after a short walk it is known as “showcase illness” or “claudicatio intermittens”. After a short rest it is possible to continue the walk. If profound vessel constrictions have al-ready set it, one experiences so called “rest pain”. The extent of pain is based upon the lo-cation of the blockage and can affect the backside area, thighs, ankle and foot. In areas with reduced blood flow increased infections, inflammation and delayed recovery after surgery or injury can set in; in some instances it can lead to tissue damage or necrosis, especially of the toes.
What are the causes?
Apart from high blood pressure, increased cholesterol levels and diabetes mellitus, smoking, overweight, lack of exercise and poor nutrition are important risk factors.
Which treatment methods are available?
The various treatment forms are based according to the stage of the disease, localization and the extent of the vessel blockage as well as individual factors, i. e. age. In order to guar-antee a therapeutic success, existing illnesses like high blood pressure and diabetes have to be treated prior to therapy. It is essential to eliminate risk factors. Smoking has to be stopped, weight reduction is suggested as well as a healthy balanced diet and sufficient ex-ercise. Injuries and infections of the affected foot, i. e. due to improper nail care, must be avoided.
Lately radiological treatment methods are on the increase. With the help of a balloon catheter it is attempted to widen the restricted vessels. Various operative methods are also available. A stripping of the vessel with special instruments is an option. During a bypass operation the body`s own vein or a synthetic vein are connected with the damaged vessel. However, with a consequent walking trainings program in combination with an infusion therapy and blood cir-culation enhancing medications an increase in blood flow can be achieved.
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