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Arteriosclerosis of the extremities Causes and Risks:
Arteriosclerosis (" hardening of the arteries ") commonly shows its effects first in the legs and feet. The arteries may become narrowed and blood flow decreases, progressing in some cases to total closure (occlusion) of the vessel. The vessel walls become less elastic and cannot dilate to allow greater blood flow when needed (such as during exercise ). Deposits of calcium in the walls of the arteries contribute to the narrowing and stiffness; this calcification may be visible on plain X-rays.
It is a common disorder usually affecting men over 50 years old, and occurring in about 6 out of 1,000 people. People who have a personal or family history of coronary artery or cerebrovascular disease , diabetes mellitus , hypertension , kidney disease involving hemodialysis , smoking , or obesity are at higher risk.
Arteriosclerosis obliterans is one form of arteriosclerosis of the extremities.
Prevention:
control risk factors such as obesity , hypertension , and smoking .
Symptoms:
Signs and Tests:
An examination may show arterial bruits (whooshing sound heard with the stethoscope over the artery), decreased or absent pulse in the extremities, or decreased blood pressure in the affected extremity.
A lipid profile may show hyperlipidemia (lipid - serum is increased, total cholesterol is increased).
Peripheral artery disease may show on: This disease may also alter the results of a febrile/cold agglutinins test.
Treatment:
Treatment focuses on the relief of symptoms and self-care to improve circulation.
Medications may be required to control the disorder, including analgesics to control pain, pentoxifylline (in some cases), and medications such as cholestyramine to reduce total cholesterol levels.
Surgery is usually performed only on severe cases where the ability to work or pursue essential activities is affected. This may consist of surgical removing of the lining of the artery (endarterectomy), repair or replacement of the vessel (grafting), or most commonly, bypass surgery using a vein or synthetic graft.
Balloon angioplasty (a similar technique to that used to open the coronary arteries, but performed on the blood vessels of the affected extremity), laser, or other treatments may be alternatives to surgery.
Self-care:
Exercise must be balanced with rest. This is often recommended as walking or other exercise performed to the point of pain, alternated with rest periods. Over time, circulation improves because of the development of collateral (new, small) blood vessels.
Stop smoking ! Smoking constricts arteries, decreases the blood's ability to carry oxygen, and increases the risk of forming clots ( thrombi and emboli ).
Foot care is particularly important if diabetes mellitus is also present. Wear shoes that fit properly. Pay attention to any cuts, scrapes, or injury--the tissues heal slowly when there is decreased circulation, and they are prone to infection.
If cholesterol is high, change the diet to a low-cholesterol diet.
Prognosis:
Arteriosclerosis of the extremities is usually controllable with treatment. Surgery provides good relief of symptoms. Complications may require amputation of the extremity.
Complications:
Call Your Healthcare Provider:
Call for an appointment with the health care provider if symptoms indicate arteriosclerosis of the extremities.
Call for an appointment with the health care provider if new symptoms develop, especially formation of new sores/ ulcers or signs of infection ( fever , redness, general ill feeling , or joint pain ).
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