The veins that feed the internal organs, arms and legs are called peripheral veins. Peripheral vascular diseases often occur as a result of narrowing or complete blockage due to atherosclerosis in the vessels feeding the legs. It is often seen in the vessels feeding the lower extremities. It manifests itself with pain and cramps in the legs upon exertion. As the disease progresses, resting leg pain and standing gangrene develop.
Frequency and risk factors:
The most important risk. Factors include smoking and diabetes. It is five times more common in men than in women. Its frequency in the adult population is around 10%. In the elderly, it varies between 12% and 20%. 40-50% of patients have coexisting coronary artery disease. In 15% of cases, there is stenosis in the carotid artery.
The underlying mechanism in peripheral vascular disease
In peripheral vascular diseases, the severity of the clinic depends on the degree of vascular stenosis and whether the collateral vessels are sufficient or not. determines. Patients with very well developed collaterals may not show symptoms. If the stenosis is over 90%, a pulse cannot be taken. During the examination, signs of pallor, coldness, necrosis or gangrene may be detected in the leg.
Diagnosis:
It is made by physical examination, ankle/brachial index, DSA (digital subtraction angiography).
Treatment:
Smoking should be stopped, blood pressure, blood sugar and cholesterol should be regulated. Obstruction can be treated percutaneously or surgically. In percutaneous treatment, different techniques are used depending on the type and location of the lesion.
In the percutaneous transluminal angioplasty procedure, the lesion area is reached with catheters by entering from different regions (groin or arm) depending on the location of the vessel to be operated with balloon and/or stent. Total occlusion. or after the stenosis is passed with a guide wire and dilated with a balloon, a stent is placed if necessary. It is very important to evaluate the suitability of the lesion for the procedure before making the decision for the procedure. There is a clot in the lesion area, it is excessively calcified, there is excessive tortuosity (folding) in the vessel before the lesion. It increases the success of the procedure and the risk of complications during the procedure.
In patients with diabetic foot (sores caused by diabetes), the blockage is usually below the knee. If there is a wound on the foot, it should be evaluated with angiography and, if appropriate, angioplasty should be performed. Wound treatment is not possible without sufficient blood reaching the foot.
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