Vascular disease

Healthy arteries are flexible and elastic and do not have any deposit. (Photo: Pixabay.com)

Do your calves or thighs hurt when you walk? If yes, this could indicate a serious disease: indeed, a closing up of blood vessels in the legs means that the arteries become narrower, which can represent a considerable risk not only for the legs, but also for the heart and the brain.

Ever heard of PVD or PAD? This abbreviation stands for an insidious disease, known as peripheral vascular disease, or peripheral artery disease. It designates the narrowing or even the closing of arteries especially in the legs but also in the arms. A long period can go by before any symptoms are observed. However, as time goes by, the oxygen supply is no longer sufficient. Typical signs are pains felt during walking, i.e. muscular pains in the feet, calves or thighs. In a restful state, these pains usually recede. People experiencing such pains often need to take a rest after a certain distance, though these walking distances always get shorter over time.

Easy to evaluate

Should unexplained symptoms appear in the legs at the age of 60 and onward, or in case of an existing risk of PVD, the arteries should always be examined. Risk factors include smoking, high blood pressure, unfavourable blood lipids, lack of exercise, unbalanced diet, and weight surplus. An evaluation can easily be performed by means of ABI measurements, otherwise known as ankle-brachial index, in which the blood pressure from the upper arm is compared to the blood pressure measured at the ankle. When the arteries are healthy, these values are equally high. However, should the blood pressure measured on the ankle be lower than that measured on the arm, this is an indication that the arteries in the legs are most likely clogged.

Treatment urgently needed

A treatment is then urgently needed, since other parts could also be affected. Many patients with PVD are also at a higher risk of suffering from a heart attack or a stroke. Should a PVD be diagnosed, two treatment paths are applied: on the one hand, a healthy lifestyle should help ensure that the arterial sclerosis does not progress any further. This means to quit smoking, increase physical activities, eat healthily, and treat the hypertension as well as the cholesterol levels. On the other hand, gait training, or gait rehabilitation, can help rebuild a new network of blood vessels in the legs. Medication will also reduce the risk of blood clots from occurring.

When gait training is no longer sufficient

Gait training is a very effective therapy. However, should it not prove sufficient, other measures can bring more visible results, for example balloon dilatation. By means of a catheter, the physician inserts a balloon into the narrowed part. The balloon is then blown up so as to expand the artery. In some cases a stent will also be applied, in order to maintain the artery open. The balloon dilation lasts about an hour and takes place without any narcosis or local anaesthesia. In some rare cases in which balloon dilation is not possible, a bypass operation can also be performed by taking a piece of another blood vessel.

Text: Medical Tribune public – 03/2017
Translation: MyH – 07/2017