Acute Vascular Occlusion
The most common cause is the clots formed on damaged heart valves breaking off and blocking the vessel in a certain area. In this case, circulation is disrupted below the area where the blocked vessel is located. Within hours, very severe pain, coldness in the standing leg, and color change (bruising) occur. This condition requires urgent surgical intervention for the first 4-6 days. During surgery, the clot in the vein is removed with the help of a special catheter. If this intervention is delayed, irreversible damage to the tissues may occur. After the surgery, an investigation is made into the cause of vascular occlusion and the patient's treatment is continued accordingly.
Chronic Occlusions
Atherosclerosis, popularly known as atherosclerosis, is chronic
strong>(slowly developing) is the most important cause of vascular occlusions. Causes of atherosclerosis include high serum cholesterol levels, hypertension, diabetes, smoking and genetic factors. As a result of atherosclerosis, a plaque forms on the vessel wall. And over time, it grows and begins to block blood flow. Clinical symptoms vary depending on the degree of obstruction in blood flow.
In mild obstruction, symptoms such as pain in the leg, numbness and weakness occur after walking for a long time. As the degree of obstruction increases, pain occurs when walking shorter distances.
In advanced stages of the disease, pain occurs while resting. Wounds begin to form in tissues that are not nourished and whose blood supply is impaired.
In patients presenting in the early stages, drug treatments are given to control atherosclerosis and support peripheral circulation, while advanced stages of the disease require surgical treatment. Surgeries generally performed are bypass surgeries in which artificial vascular grafts are placed to carry blood to the area below the blocked artery.
Burger Disease
It is a form of chronic artery occlusion. Another common form is Buerger's disease. It is a disease that frequently affects the small arteries in the legs and often the small veins and nerve sheaths in young male smokers. Leg pain when walking, coldness in the leg, sensitivity to cold It has symptoms such as recurrent attacks of superficial vein inflammation. In later periods, severe pain, wound formations called ulcers and gangrene are frequently observed. Exacerbation of the disease can be prevented to a large extent by quitting smoking in the early period. However, it often requires surgical intervention.
Raynaud (Reyno) Disease
Raynaud's disease is a disease that affects the vessels in the fingers and toes, nose and ears. It progresses with attacks that occur with sudden narrowing of the vessels in the mentioned areas. It can be a single disease or accompany other diseases, in which case it is called "Raynaud's syndrome". Raynoud syndrome most often occurs together with connective tissue diseases. These diseases cause thickening of the vascular wall, causing the vessels to shrink very quickly. Arterial disorders, some blood pressure and migraine medications can cause Raynaud's syndrome.
Its prevalence in the population is between 5-10% and occurs most in women between the ages of 15-40. Its incidence increases in cold climates. Attacks in patients mostly occur with exposure to cold and sometimes with stress. Fingers and toes are usually affected. However, sometimes symptoms also occur in the nose, lips and ears.
Normally, when faced with cold, the body tries to reduce heat loss in order to maintain its temperature. For this reason, the veins on the surface shrink. In people with Raynaud's disease, this response is very sudden and severe. And as a result, the blood flow to the hands and feet, which are the end points of the body, is seriously reduced.
When the attack begins, first whitening, then bruising and redness occur in the fingers and toes. However, this classic color change may not occur in all patients. Whitening is due to the sudden closure of the small arteries in the fingers, and bruising is due to the inability of oxygen-rich blood to reach the tissues because the vessels are closed. In the meantime, numbness may occur in the fingers. When the veins open and blood flow improves, the color turns red. After the attack passes, there may be a tingling sensation in the fingers. The length of attacks can vary from a few minutes to several hours. As tissue nutrition is impaired with recurrent attacks, fingertip Ulcers and gangrene may occur on the skin. The aim of the treatment is to reduce the frequency and severity of attacks and thus prevent permanent tissue damage. The frequency and severity of attacks can be reduced with some simple measures. The most important point is to protect from the cold. It is necessary to protect not only the hands and feet but also the whole body from the cold. Since most of the body heat is lost through the scalp, it is important to use a hat as well as gloves and socks.
These patients should stay away from smoking. Because nicotine can trigger attacks. It may be beneficial to seek professional help regarding stress management.
The most reliable drug treatment is calcium channel blockers. They widen the vessels by causing the smooth muscles in the vessel wall to relax.
Alpha blockers, which have an opposing effect on the activity of the norepinephrine hormone, which causes narrowing of the vessels, are another group of drugs used in the treatment. Other vasodilator drug groups can also be tried in treatment. In severe patients with wounds on the fingertips, surgical methods can be applied to block the sympathetic nerve activity that causes narrowing of the vessels.(sympathetic nerve blockade or sympathectomy) While primary Raynaud's disease responds better to treatment, Raynaud's syndrome is more difficult to treat.
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