Atheroclerosis, or hardening of the arteries, is caused
by the accumulation of a fatty substance called plaque on the inside of the
walls of the arteries. This is a condition that affects up to 35% of
Americans. Atherosclerosis can cause the narrowing of any of the arteries
throughout the body, decreasing blood supply to a particular limb or organ.
Narrowing of the arteries decreases the blood supply to the muscles and
tissues in the surrounding area, resulting in poor circulation. Lower
extremity arterial occlusive disease (occurring in the legs and feet) is often
present in conjunction with other conditions, such as carotid artery disease and
heart disease.
Risk factors for arterial occlusive disease
include:
• Family history of atherosclerosis
• High
blood pressure
• Diabetes
• High cholesterol
• Advanced
age
• Sedentary lifestyle
• Smoking
How is Lower Extremity Arterial Occlusive Disease
Diagnosed?
Symptoms depend on the organ affected, severity of
disease and the suddenness of the block. The symptoms of lower extremity
arterial occlusive disease include:
• Pain in the calves or thighs while
walking
• Pain in the feet at rest
• Coolness of legs and
feet
• Poor healing of wounds in the extremity
• Ulcers of the
feet and legs
• Black discoloration of the toes or skin (gangrene)
Pain in the calves or thighs while walking is the most
common symptom of lower extremity occlusive disease. Some people may also
experience numbness, weakness, or cold in the feet or legs. As the disease
progresses, pain may also be felt at rest in the toes and ulcers may develop.
These ulcers can turn gangrenous if untreated.
In order to diagnose the severity of the condition, the patient’s blood
pressure is taken in the arm and compared to the blood pressure measurement
taken in the ankle. The result of this test, called the ankle brachial
index (ABI) will evaluate the extent to which the blood supply is limited in the
leg.
Imaging tests may also be necessary to determine the location and the
extent of the arterial narrowing (stenosis) in the legs. These tests may
include angiography or Magnetic Resonance Angiography (MRA).
How is Lower Extremity Arterial Occlusive Disease
Treated?
If symptoms
are mild to moderate, the disease can be well managed by
lifestyle changes such as smoking cessation, regular exercise, and management of
related medical conditions such as diabetes, high blood pressure and high
cholesterol levels. Exercise can help tremendously in relieving
symptoms. Blood-thinning drugs or other kinds of medication may also be
prescribed.
In some cases, a procedure may be required to relieve the narrowing in the
artery and to restore blood flow to the leg. The arterial stenosis may be
treated using minimally invasive procedures such as angioplasty and stenting to
improve blood supply to the affected extremity.
However, if the disease is advanced, or if it occurs in
an artery that is difficult to reach with a catheter, arterial bypass surgery
may be necessary in order to restore blood flow.
For more information about the treatment of arterial
occlusive disease, call LifeBridge Health at 410-601-WELL (9355).
