Blocked artery in leg
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Understanding Blocked Arteries in the Leg: Peripheral Artery Disease (PAD)
Peripheral Artery Disease (PAD) Overview
Peripheral Artery Disease (PAD) is a condition characterized by the narrowing or blockage of the arteries that supply blood to the lower limbs, primarily due to atherosclerosis, which is the buildup of fatty deposits and cholesterol in the arterial walls . This condition reduces blood flow to the legs and feet, leading to symptoms such as pain, discomfort, and in severe cases, critical limb ischemia (CLI) .
Symptoms and Diagnosis of PAD
Common Symptoms
The most common symptom of PAD is intermittent claudication, which is pain or discomfort in the calf muscles during walking that is relieved by rest. Other symptoms include leg pain at rest, poor wound healing on the feet, and in severe cases, gangrene .
Diagnostic Techniques
Arteriography is a key diagnostic technique for identifying blockages in the leg arteries. This involves the use of a balloon catheter to produce arterial occlusion and visualize the arteries and collateral circulation. Additionally, camera-based plantar perfusion imaging is an emerging non-contact method that measures skin perfusion to detect lower limb arterial blockages.
Treatment Options for Blocked Arteries in the Leg
Surgical and Endovascular Interventions
Revascularization is a common treatment for severe PAD, involving procedures such as bypass surgery, endarterectomy, and angioplasty . Bypass surgery often uses the patient's own saphenous vein or synthetic tubes to redirect blood flow around the blocked artery.
Mechanical Thrombectomy
Mechanical thrombectomy (MT) is another technique used to remove blood clots from the arteries or veins in the lower limbs. This method has shown greater technical success and reduced hospital stays compared to catheter-directed thrombolysis (CDT) alone, although the evidence is still uncertain.
Management and Prognosis
Long-term Management
Long-term management of PAD includes lifestyle changes such as regular exercise and smoking cessation, which can improve symptoms of intermittent claudication. Patients with PAD are also at higher risk for cardiovascular events and should be evaluated for heart and carotid artery diseases.
Prognosis and Recurrence
Despite surgical interventions, there is a significant recurrence rate of arterial blockages. Studies have shown that up to 26% of patients experience recurrence within three years post-surgery, with the highest recurrence rate occurring within the first 30 days.
Conclusion
Peripheral Artery Disease (PAD) is a serious condition that can lead to significant morbidity if not properly managed. Early diagnosis through techniques like arteriography and plantar perfusion imaging, combined with appropriate surgical or endovascular interventions, can improve outcomes. However, long-term management and lifestyle modifications are crucial to prevent recurrence and manage symptoms effectively.
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