About occlusive peripheral vascular disease
What is occlusive peripheral vascular disease?
Buerger's disease, also known as thromboangiitis obliterans, is a rare disorder that, in most cases, affects young or middle-aged male cigarette smokers. It is characterized by narrowing or blockage (occlusion) of the veins and arteries of the extremities, resulting in reduced blood flow to these areas (peripheral vascular disease). The legs are affected more often than the arms. In most cases, the first symptom is extreme pain of the lower arms and legs while at rest. Affected individuals may also experience cramping in the legs when they walk that, in rare cases, may cause limping (claudication). In addition, affected individuals may have sores (ulcers) on the extremities, numbness and tingling and a lack of normal blood flow to the fingers and/or toes when exposed to cold temperatures (Raynaud's phenomenon), and/or inflammation and clotting of certain veins (thrombophlebitis). In severe cases, individuals with Buerger's disease may exhibit tissue death (gangrene) of affected limbs. The exact cause of Buerger's disease is not known; however, most affected individuals are heavy tobacco users.
What are the symptoms for occlusive peripheral vascular disease?
Claudication symptoms include muscle Pain or Cramping in the legs or arms that begins during exercise and ends with rest. The Pain is most commonly felt in the calf. The Pain ranges from mild to severe. Severe leg Pain may make it hard to walk or do other types of physical activity.
Other peripheral artery disease symptoms may include:
- Coldness in the lower leg or foot, especially when compared with the other side
- Leg Numbness or weakness
- No pulse or a weak pulse in the legs or feet
- Painful Cramping in one or both of the hips, thighs or calf muscles after certain activities, such as walking or climbing stairs
- Shiny skin on the legs
- Skin color changes on the legs
- Slower growth of the toenails
- Sores on the toes, feet or legs that won't heal
- Pain when using the arms, such as Aching and Cramping when knitting, writing or doing other manual tasks
- Erectile dysfunction
- Hair loss or slower hair growth on the legs
If peripheral artery disease gets worse, Pain may occur during rest or when lying down. The Pain may interrupt sleep. Hanging the legs over the edge of the bed or walking may temporarily relieve the pain.
What are the causes for occlusive peripheral vascular disease?
Development of atherosclerosis
If there are too many cholesterol particles in the blood, cholesterol may build up on the artery walls. Eventually, deposits called plaques may form. The deposits may narrow — or block — the arteries. If the plaques burst, a blood clot can form.
Peripheral artery disease is often caused by a buildup of fatty, cholesterol-containing deposits (plaques) on artery walls. This process is called atherosclerosis. It reduces blood flow through the arteries.
Atherosclerosis affects arteries throughout the body. When it occurs in the arteries supplying blood to the limbs, it causes peripheral artery disease.
Less common causes of peripheral artery disease include:
- Blood vessel inflammation
- Injury to the arms or legs
- Changes in the muscles or ligaments
- Radiation exposure
What are the treatments for occlusive peripheral vascular disease?
The goals of treatment for peripheral artery disease are:
- Manage symptoms, such as leg pain, so exercise isn't uncomfortable
- Improve artery health to reduce the risk of heart attack and stroke
Treatments for peripheral artery disease includes lifestyle changes and sometimes, medication.
Lifestyle changes can help improve symptoms, especially early in the course of peripheral artery disease. If you smoke, quitting is the single most important thing you can do to reduce the risk of complications. Walking or doing other exercise on a regular, scheduled basis (supervised exercise training) can improve symptoms dramatically.
Surgeries or other procedures Graft bypass
A graft is used to redirect blood flow around a blocked or narrowed artery. A graft can be a blood vessel from another part of the body or a synthetic substitute.
In some cases, angioplasty or surgery may be necessary to treat peripheral artery disease that's causing claudication:
- Angioplasty and stent placement. This procedure is done to open clogged arteries. It can diagnose and treat a blocked vessel at the same time. The health care provider guides a thin, flexible tube (catheter) to the narrowed part of the artery. A tiny balloon is inflated to widen the blocked artery and improve blood flow. A small wire mesh tube (stent) may be placed in the artery to keep the artery open.
- Bypass surgery. The surgeon creates a path around the blocked artery using either a healthy blood vessel from another part of the body or a synthetic one.
- Thrombolytic therapy. If a blood clot is blocking an artery, a clot-dissolving drug may be given directly into the affected artery.
What are the risk factors for occlusive peripheral vascular disease?
Smoking or having diabetes greatly increases the risk of developing peripheral artery disease.Other things that increase the risk of peripheral artery disease include:
- A family history of peripheral artery disease, heart disease or stroke
- High blood pressure
- High cholesterol
- High levels of an amino acid called homocysteine, which increase the risk for coronary artery disease
- Increasing age, especially after 65 (or after 50 if you have risk factors for atherosclerosis)
- Obesity (a body mass index over 30)
Is there a cure/medications for occlusive peripheral vascular disease?
If peripheral artery disease (PAD) is causing symptoms, your provider may prescribe medicine. Medications for PAD may include:
- Cholesterol drugs. Medications called statins are commonly prescribed for people with peripheral artery disease. Statins help lower bad cholesterol and reduce plaque buildup in the arteries. The drugs also lower the risk of heart attacks and strokes. If you have PAD, ask your provider what your cholesterol numbers should be.
- Blood pressure drugs. Uncontrolled high blood pressure can make arteries stiff and hard. This can slow the flow of blood. Ask your health care provider what blood pressure goal is best for you. If you have high blood pressure, your provider may prescribe medications to lower it.
- Medications to control blood sugar. If you have diabetes, controlling your blood sugar levels becomes even more important. Talk with your provider about your blood sugar goals and how to reach them.
- Medications to prevent blood clots. Peripheral artery disease is related to reduced blood flow to the limbs. So, medicines may be given to improve blood flow. Aspirin or another medication, such as clopidogrel (Plavix), may be used to prevent blood clotting.
- Medications for leg pain. The drug cilostazol thins the blood and widens blood vessels. It increases blood flow to the limbs. The drug specifically helps treat leg pain in people who have peripheral artery disease. Common side effects of this medication include headache and diarrhea. An alternative medication is pentoxifylline. Side effects are rare with this medication, but it generally doesn't work as well as cilostazol.