Pain in the legs on walking or at night , Non- Healing Leg Wound / Ulcer or Pigmentation and Varicose Veins are only symptoms of an arterial or Venous disease.
The disease could be a blockade in the arterial blood supply or an improper venous blood drainage.
Prompt diagnosis and treatment helps prevent an Amputation of the limb.
What is Atherosclerosis ?
Atherosclerosis is a process that may affect any artery in the body and cause obstruction (some patients call these “blockages”) of the involved blood vessel.
What are the “Risk Factor”s for Atherosclerosis ?
- High Cholesterol / Triglycerides,
- Positive Family history of vascular disease and
- Chronic Smokers.
What are the Symptoms and Signs of Atherosclerosis in the Limbs ?
When atherosclerosis blocks the arteries that provide blood supply to the legs, the patient may have
- Difficulty walking long distances
- Pain in the foor and/or leg at rest/night
- Non-Healing Leg wounds/ulcers
- Loss of hair on the legs
- Brittle nails,
- Blackish Discoloration of fingers/toes
What are the tests needed to confirm the diagnosis?
- A Colour Doppler Arterial Study is generally sufficient for confirmation of the disease.
- A Peripheral Angiography is required in select cases planned for Revascularisation – Bypass or Angioplasty.
Newer techniques of Multi-Slice CT or MR Angiography are available today and are Out-Patient procedures needing an injection into a hand vein rather than a direct arterial puncture and injection.
What is the treatment of Arterial Occlusive Disease ?
If a patient is severely limited by disabling symptoms, it may be necessary to do procedures such as angioplasty or bypass surgery after angiographic assessment, to relieve the symptoms and improve the ability to walk. We often use a combination of these procedures on patients who have multiple blocked arteries.
Surgery may be a Bypass or an Endarterectomy.
Bypass is usually done using the patient’s own leg vein as the bypass graft. The surgery is usually done with Epidural analgesia i.e an injection at the back. No General Anesthesia is usually used. This reduced the hospital stay remarkably and avoids the need for life-long anticoagulation which is needed if a prosthetic graft is used.
A control of the Risk-factors is important for recurrence of the process at the same bypass/angioplasty site, or a new location anywhere in the body.