Arteriopathy obliterans | Symptoms, diagnosis & treatment in Turkey

Arteriosclerosis Obliterans : What is it?

Arteriosclerosis obliterans is a progressive vascular condition characterized by narrowing or blockage of the arteries, which reduces blood flow to the limbs. Over time, this can lead to pain, numbness, difficulty walking, and in severe cases, tissue damage.

Early detection and treatment are essential to prevent complications, improve circulation, and maintain mobility.

Causes of arteriosclerosis obliterans

Obliterate arteriosclerosis results from the gradual accumulation of fatty deposits (atheromatous plaques) in the arterial walls. This phenomenon, known as atherosclerosis, is favored by several factors, including :

• Age and gender: AOMI is more common in the elderly and in men.
• Lifestyle: Smoking, high blood pressure, diabetes, high cholesterol and obesity are major risk factors.
• Family history: People with a family history of cardiovascular disease are at greater risk.
• Other factors: Some less common conditions, such as certain kidney diseases or congenital heart defects, may also predispose to AOMI.

Symptoms of PAD

The symptoms of PAD vary, but intermittent claudication is one of the most common. It is characterized by muscle pain, cramps or fatigue in the legs during exertion (walking, climbing stairs),which disappears at rest.

Other symptoms may also occur, such as:

• Pain in the hips or thighs.
• Numbness and tingling.
• Cold in the lower limbs.
• Inflammation.
• Changes in skin color.
• Slower nail growth.

In some cases, arterial occlusive disease may be asymptomatic.

Diagnosis of obliterating arteriopathy

The diagnosis of obliterative arteriopathy is based on several tests:

• Clinical examination: The doctor will ask the patient about his or her symptoms and perform a physical examination.
• Ankle-brachial index (ABI): This test compares blood pressure in the ankle and arm. A low ABI indicates blockage of the arteries in the legs.
• Echodoppler: This test uses ultrasound to visualize blood flow in the arteries.
• Angiography: This test uses a contrast dye injected into the arteries to produce detailed images of the blood vessels.
• Other tests: Blood tests (CRP, cholesterol) may be performed to assess cardiovascular risk.

Treatment of obliterating arterial disease in Turkey

Treatments for obliterative arterial disease aim to improve blood circulation and relieve symptoms. Therapeutic approaches in Turkey include

Medication treatment

The initial treatment of PAD is based on medications, including:

• Antiplatelet agents: Prevent the formation of blood clots that can worsen arterial blockage.
• Vasodilators: Dilate blood vessels, making it easier for blood to circulate.
• Statins: Lower levels of bad cholesterol (LDL),which may help slow disease progression.

Lifestyle changes

Lifestyle changes play an important role in the treatment of AOMI:

• Smoking cessation: Smoking accelerates atherosclerosis.
• Eat a balanced diet: A diet rich in fruits, vegetables, and fiber and low in saturated fat is beneficial.
• Regular physical activity: Individualized exercise improves circulation.

Surgical procedures

Obliterative arterial disease of the lower limbs (OADL),characterized by narrowing of the leg arteries, may require surgical intervention when medical treatment proves inadequate.
The choice of surgical technique depends on several factors, including:

• The location and extent of the arterial lesions: Affected arteries may be located in the hips, thighs, or calves.
• The severity of symptoms: Pain when walking, wounds that do not heal, etc.
• The patient's general health: Other comorbidities may affect the choice of treatment.

Surgical treatment of IMA

Three main surgical techniques are used to treat IMA:

Angioplasty with or without stent placement

In this procedure, an inflatable balloon is inserted through a small incision, usually in the groin, to widen the narrowed artery. A stent (a small metal device) is often placed to keep the artery open. Stents can be plain or coated with a drug to prevent the narrowing from recurring.

Angioplasty is a less invasive procedure than other techniques and is often done under local anesthesia. However, there is a risk of long-term narrowing of the artery, which sometimes requires further intervention.

Endarterectomy technique

This procedure removes the atheromatous plaque (fatty buildup) that is blocking the artery. It is usually performed on large caliber arteries (hips, thighs).

Endarterectomy is an effective technique for large lesions. However, it is a more extensive procedure than angioplasty, requiring general anesthesia and a larger incision.

Coronary artery bypass surgery

Bypass surgery consists of creating a "detour" using a piece of vein or a synthetic graft to connect the two ends of the diseased artery. This technique is used when lesions are too long or too complex to be treated by angioplasty or endarterectomy.

This technique permanently restores circulation. However, it is a more complex procedure that requires general anesthesia and a longer hospital stay.

The choice of the most appropriate technique is made in consultation with the vascular surgeon, depending on the characteristics of each patient and the disease.

Benefits of surgery

Surgical treatment of AOMI aims to:

• Relieve pain: By improving blood circulation, walking pain is significantly reduced.
• Promote wound healing: Improved blood flow allows wounds to heal more quickly.
• Prevent complications: Amputation, a serious complication of AOMI, can be avoided with proper treatment.
• Improve quality of life: With improved mobility, patients can resume daily and social activities.
• After surgery, regular monitoring is required to assess the effectiveness of the treatment and to detect any complications. Medications may be prescribed to prevent blood clot formation and reduce the risk of recurrence.

It's important to note that every patient is unique and the results of surgery may vary. Don't hesitate to ask your doctor in Turkey any questions you may have to better understand the different treatment options available to you.