Endarteritis
General characteristics of the disease
Endarteritis (the most common synonym for "obliterating endarteritis") is a serious, steadily progressive disease of the arteries, leading to the complete closure of their lumen, impaired circulation in the affected organ and the development of gangrene. Most often, endarteritis affects the vessels of the legs. Symptoms of endarteritis most often appear in middle-aged and young men who abuse smoking. Treatment of endarteritis is quite effective only in the early stages of the disease, with deep tissue damage and the development of gangrene, amputation of the limbs is indicated.
The reasons for the development of endarteritis
The nature of obliterating endarteritis is not fully established. Most doctors believe that autoimmune antibodies are to blame for the development of endarteritis of the lower extremities, which cause inflammatory damage to the arterial wall, as a result of which connective tissue develops, and the lumen of the vessel narrows. Inflammation and sclerosis affect the fatty tissue surrounding the vessels. Connective tissue compresses the arteries from the outside, which further exacerbates the situation.
In addition, a connection was established between the development of obliterating endarteritis with chronic poisoning of the body with nicotine and other poisons, neuropsychic stress and regular hypothermia of the legs.
Endarteritis - symptoms of the development of the disease
Patients with endarteritis of the lower extremities pay attention to the following symptoms:
- recurrent feeling of cold feet
- a feeling of "creeping"
- increased sweating of the lower extremities
- pallor and dryness of the skin of the legs
- brittle and blue toenails
- fast fatigue when walking
- cramps and pain when walking, and later at rest
- reduction of pulsation on the arteries of the rear of the foot
- the appearance of edema of the lower extremities
- the formation of ulcers on the legs
Intermittent claudication - the most important symptom of endarteritis
A patient with obliterating endarteritis can be recognized on the street by a specific gait. These patients walk, stopping after a few steps. This is due to the fact that due to a lack of oxygen supply to the tissues through the narrowed vessels, spasm develops in the calf muscles and severe pain occurs.
After stopping, the oxygen demand of the muscles decreases slightly, the blood supply improves, the spasm disappears and the pain disappears. But as soon as a person with endarteritis begins to move, everything repeats from the beginning.
Development of endarteritis
For obliterating endarteritis, a progressive cyclical course with alternating periods of exacerbation and remission is characteristic. There are several phases in its development.
- Nerve dystrophy phase. It is characterized by the development of dystrophic processes in the nerve endings approaching the vessels. The lumen of the vessel narrows slightly, the nutrition of the tissues does not change, since the collateral circulation system operates. In this phase, the symptoms of endarteritis do not appear yet, but the disease is already progressing.
- The phase of spasm of large vessels. The lumen of the arteries is narrowed, the collateral circulation system cannot cope with the increased load, and symptoms such as cold extremities, fatigue and intermittent claudication appear. Treatment of endarteritis usually begins at this stage of the disease.
- The phase of proliferation of connective tissue. Due to the progressive development of connective tissue in all layers of the vascular wall and around the vascular tissue, pain in the legs at rest and a decrease in pulsation in the arteries appear. This is a far advanced stage of lower limb endarteritis.
- Phase of complete obliteration of blood vessels or their thrombosis. This is the stage of outcome of obliterating endarteritis. As a result of these processes, irreversible consequences develop in the limb - soft tissue necrosis and gangrene.
In the later stages of the disease, characteristic vascular changes can be found in all internal organs, including the heart and brain.
Diagnostics of the endarteritis of the lower extremities
As soon as symptoms of endarteritis appear, it is necessary to consult a doctor - surgeon. With the help of modern research methods, the doctor will be able to make the correct diagnosis and prescribe treatment. To establish the diagnosis of endarteritis, volumetric sphygmography (measurement of pulsation), Doppler ultrasound, rheovasography and radiopaque examination of the vessels of the lower extremities are used.
Endarteritis treatment
Obliterating endarteritis is a disease for the treatment of which modern medicine does not have enough means and methods. At the moment, it is impossible to achieve the reverse development of connective tissue; it is only possible to slow down the process of its formation and alleviate the patient's condition.
A prerequisite for the treatment of endarteritis is the complete refusal of the patient from smoking and drinking alcohol, since these substances contribute to prolonged vasospasm and aggravate the condition.
A patient with endarteritis is not shown a special diet, however, one should not overeat, since excess body weight creates an additional load on the lower limbs. Overweight patients are advised to lose weight, and for this, reduce the daily calorie content of food and exclude flour, fatty and sweet foods.
With endarteritis of the lower extremities, it is useful to move a lot, you need to walk for at least an hour a day, despite attacks of intermittent claudication. If pain occurs, you need to stop and wait until it subsides completely. Cycling and swimming in water with a temperature of at least 22-24 degrees will be beneficial.
A patient with endarteritis needs to monitor the hygienic condition of the legs - before going to bed, wash them with warm water and soap, wipe them dry and lubricate them with fat cream.
If these methods do not help, the symptoms of endarteritis increase, and the patient's condition worsens, it is necessary to resort to surgical methods of treating endarteritis:
- Sympathectomy - removal of the second and third lumbar ganglia in the borderline sympathetic trunk, which leads to paretic expansion of collateral vessels and improved blood supply to the limb.
- Bypass surgery - creating a vascular anastomosis bypassing the affected area of the artery. This is one of the most effective treatments for endarteritis.
- Thrombintymectomy - removal of a blood clot that blocks the lumen of a vessel affected by endarteritis, together with a pathologically enlarged intima (inner lining of an artery).
- Amputation of a limb - this extreme measure is carried out in cases when, as a result of obliterating endarteritis, soft tissue necrosis and gangrene of the limb develop, and the patient is constantly tormented by intolerable pain.
In order to prevent this sad outcome, you need a timely visit to a doctor, careful adherence to all his recommendations and a healthy lifestyle.
YouTube video related to the article:
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
