Arterial disease
The underlying cause of arterial disease is mostly atherosclerosis: hardening of the wall of the vessel which eventually leads to either narrowing of the vessel or weakening of the vessel wall which will then lead to an aneurysm (dilatation of the artery) forming.
What are the related symptoms of an arterial disease?
In most cases, symptoms of arterial disease are not present or not noticeable. Possible symptoms include:
- Hair loss on the feet and legs
- Intermittent claudication, when you feel pain on your thigh or calf when walking or climbing stairs
- Leg weakness
- Numbness in the legs
- Sores and ulcers on the legs and feet which take time to heal or never heal
- Shiny, pale or bluish skin on the legs
The risk factors for developing atherosclerosis (and therefore, arterial disease) are the following:
Major:
- Smoking
- High blood pressure
- Diabetes
- High cholesterol
Minor:
- Age
- Obesity
- Being a male
- Hypercoagulability
- High homocysteine levels in the blood
Treatment options for arterial disease:
Treating arterial disease, the surgeon will usually employ one or a combination of the following strategies:
- Lifestyle modification (weight loss, exercise, cessation of smoking)
- Medical management (controlling diabetes, hypertension, high cholesterol, treatment to thin the blood, etc.)
- Endovascular therapy (stenting or angioplasty)
- Open surgery (bypass or aneurysm repair procedures)
- Amputation (last resort)
Endovascular therapy:
The importance and availability of endovascular therapy have grown exponentially over the last 2 decades. After gaining access through a peripheral artery the entire vascular system can be accessed. The surgeon may use specially designed balloon-tipped catheters to dilate narrow areas in the arteries, and 'stents' can be deployed and left in the arteries to keep them open.
Open surgery:
Surgery still plays a major role in the treatment of arterial disease; the surgeon may recommend it when endovascular therapy is not possible or has failed. Surgery usually entails either an endarterectomy (opening the artery and cleaning out the inside) or a bypass procedure. With a bypass procedure, a segment of the patient's own vein or a synthetic tube is used to bypass the diseased segment of the artery and restore adequate blood flow.
Amputation:
Amputation is usually a last resort. The surgeon may recommend amputation if arterial disease is untreatable or because the limb is no longer salvageable. The aim will always be to preserve as much limb function as possible.
Arterial disease will usually present as either peripheral vascular disease or aneurysmal disease.