One of the most unpleasant vascular diseases is the obliterating endarteritis, which affects the lower limbs and is accompanied by narrowing of the arteries lumen (stenosis) or its complete closure (obliteration). The disease has a progressive nature and is the most common cause of leg amputation. Suffer from the endarteritis of the lower extremities are mostly men: women account for only 1% of patients.
Causes of the disease
Doctors continue to discuss on the causes of such a vascular lesion, but agree that the obliterating endarteritis of the lower limbs predispose several factors at once, including:
- smoking;
- frostbite of the feet;
- chronic intoxication;
- chronic neuritis of the sciatic nerve ;
- injuries.
Some scientists managed to find the relationship between syphilis, typhus, foot epidermophyte and obliterating endarteritis of the vessels of the lower limbs. There is a theory about the autoimmune nature of this disease. In the development of it plays a role and a violation of the hormonal function of the adrenal glands.
It is worthwhile to distinguish obliterating endarteritis and obliterating atherosclerosis. The latter suffer from elderly people against systemic atherosclerosis, and the disease is accompanied by a narrowing of the lumen of all major arteries. When endarteritis is observed stenosis and obliteration of peripheral vessels in the area of the feet and shins, and they suffer from people 20-40 years old. The symptoms of both diseases are similar, although the causes are different.
Symptoms of obliterating endarteritis
Depending on the degree of closure of the lumen of the vessels, the four phases of the disease are distinguished:
- In the neurovascular endings, dystrophic changes begin to occur, but the patient still does not experience any discomfort.
- There is a spasm of the vessels, which is expressed by fatigue of the legs, pains, lameness. The limbs are cold.
- The pulsation of blood in the arteries is weakened, the patient complains of pain in the limbs, which arises even at rest.
- Vessels are completely clogged, tissue (necrosis) and gangrene die off.
Sometimes endarteritis in women and men begins with the manifestations of migrating thrombophlebitis - the subcutaneous veins on the feet and legs are clogged with thrombi.
In the second stage there is a slowing of the growth of nails and hair loss on the legs, blue skin, feel the pulse on both extremities or one of them fails.
The third phase is characterized by muscle atrophy and the appearance of trophic ulcers on the fingers and feet. After this, the disease passes to the final stage (wet or dry gangrene), and treatment of the obliterating endarteritis of the lower extremities implies, first of all, amputation.
Sometimes the disease occurs in a generalized form - then not only the vessels of the legs are clogged, but also:
- cerebral and coronary arteries;
- visceral branches of the abdominal aorta;
- branches of the arch of the aorta.
Diagnosis of the disease
When diagnosing a doctor, the doctor should be excluded:
- diabetic macroangiopathy;
- discogenic myelopathy;
- phlebeurysm;
- arthrosis, arthritis, sciatica , which have a noticeable pain in the legs.
During the diagnosis, the lower limbs are examined by:
- UZDG (ultrasound dopplerography);
- thermography;
- rheovasography;
- oscillography;
- angiography;
- capillaroscopy.
Treatment of obliterating endarteritis
If the disease is detected in the early stages, conservative treatment is performed to relieve vasospasm, prevent clogging of blood clots and stop inflammation. To do this, use antispasmodics, antibiotics, corticosteroids, vitamins, anticoagulants, antiaggregants. Physiotherapeutic procedures are useful.
In the treatment of endarteritis, smoking cessation is mandatory.