This is an inflammatory pathology of the peripheral arteries. As a result of the development of this disease, there is a narrowing of these arteries and a deterioration of the blood circulation process, which provokes a complete blockage of blood vessels and tissue hypoxia, gangrene.
Usually, the pathology affects the area of the feet and legs. Since less and less blood and oxygen, respectively, enter the vessels, soft tissues gradually wither, after which they simply cease to function and die. Pathology is more common among middle-aged men, but can also occur in women.
Depending on the stage of development of the pathology, the symptoms can vary significantly. There may be an alternation of periodic exacerbations of the disease and remissions, which can last a very long time, misleading the patient.
Because of this, people often think that the problem is gone and delay the visit to the doctor. This is actually a huge mistake. Since the disease simply falls into the so-called sleep mode, in order to soon worsen with a new intensity and already in a more difficult stage.
The same reason often does not make it possible to recognize endarteritis in time. Among the most common symptoms are:
- the appearance of a sharp pain in the lower extremities, which can occur both at rest, and during movement, physical exertion;
- fatigue during walking and the appearance of pain, a feeling of heaviness in the calf;
- the appearance of small wounds on the toes that do not heal long enough, regardless of treatment;
- the appearance of numbness of the feet and a frequent sensation of coldness in the legs;
- swelling of the lower extremities appears;
- foot hyperhidrosis;
- poor palpation of the pulse, sometimes the patient can’t even feel the pulse at all;
- fragility of nails, deformation;
- cramps in the legs, which first appear at night, after – while walking, and then completely permanently;
- the skin on the lower extremities becomes pale, the legs are always cold, a bluish tint may appear.
Depending on the stage of development of the disease, the intensity of the symptoms and the treatment itself may vary.
An informational video that details what the disease is, how it manifests itself, and how it can be cured.
Unfortunately, it is impossible to completely get rid of this pathology. However, it is possible to significantly slow down the development of the disease, reduce unpleasant and painful symptoms, and improve the patient’s condition.
Alternative methods can also be used as an adjunct, but only in conjunction with medical treatment and after discussion with a doctor. Be sure to abandon bad habits – smoking, alcohol, and even from constant overeating. Establish a regimen and start eating the right, healthy food.
Drug treatment is mandatory, since in the case of the development of this pathology, traditional medicine will not succeed. Typically, doctors prescribe these types of drugs for the treatment of obliterating endarteritis of the vessels of the lower extremities:
- antihistamines – Cetrin, Suprastin, Loratadin, L-cet;
- muscle relaxants, among which the most popular are Tifen, Redergam and Angiotrophin;
- blood thinners – Trental or Aspirin;
- hormones of the adrenal cortex – Prednisone;
- B, E, C and PP vitamins.
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- Folk remedies
- In detail about obliterating endarteritis
- Stages of development
- Arterial spasm
- Obliterating endarteritis: classification and stages of the development of the disease
- How is the diagnosis?
- Development of the disease
- Physiotherapy for Endarteritis
- Nutrition for Endarteritis
- Endarteritis and atherosclerosis
- Are there effective preventative measures?
- How does pathology develop?
- clinical picture
- Establishing diagnosis
With the help of physiotherapeutic procedures, it is possible to improve the blood circulation in the lower extremities.
The doctor may prescribe these types of physiotherapy procedures:
- thermal – applications of paraffin and ozokerite, heating of various classifications, Bernard currents;
- magnetotherapy – therapy using a high frequency magnetic field;
- baromassage – the patient’s legs are placed in a special pressure chamber, while they are alternately exposed to low and high pressure;
- dynamic currents;
- hot baths using coniferous extract, sea salt and other herbal remedies.
In the absence of the effect of conservative therapy or at more serious stages of the disease, the doctor may decide on surgery.
A treatment called sympathectomy may be prescribed to treat lower limb endarteritis. This is a dissection of nerve tissues that cause vasospasm.
In second place among surgical methods of therapy is shunting. This is the artificial creation of additional circulatory pathways using shunts. Artificial arteries of this kind can bypass damaged areas of blood vessels.
In more severe cases, partial or complete removal of the artery and its prosthetics are required. When there are blood clots in the vessels and arteries, thrombintimectomy may be necessary. This is the surgical removal of blood clots that block the path to the arteries for circulation.
At the most advanced stages, an operation can be prescribed, during which the sites of dry gangrene are removed. And in the case of the last stage of obliterating endarteritis of the vessels of the lower extremities – complete amputation of the legs. This is the most extreme measure that doctors usually take to save a person’s life, when the effect of other methods of therapy is absolutely not observed, while the disease progresses.
Alternative treatment of alternative medicine in such a case cannot be considered. It can be used only in combination with a full-fledged medical treatment, after consulting a doctor.
Alternative methods for endarteritis will help slightly alleviate the patient’s condition in the initial stages of the development of pathology. Basically, all recipes are based on herbs and herbal preparations, characterized by a strengthening and regenerating effect on the vascular walls.
With these simple recipes, you can reduce the inflammatory process and slightly reduce the symptoms of the disease:
- In equal amounts, take chamomile, corn stigmas, yarrow, St. John’s wort and birch buds, and mix all these medicinal herbs. For two tablespoons of collection you will need a liter of boiling water. Let it brew for two hours. Having filtered the broth, consume 250 ml twice a day – in the morning and in the evening before eating.
- Take 80 grams of horsetail, 200 grams of dry hawthorn and 120 grams of bird highlander. One tablespoon of this collection will need half a liter of boiling water. After the broth is infused, strain it and use it three times a day, one tablespoon before meals.
- Grind one lemon and an orange with a grater, blender or meat grinder, add one tablespoon of honey. Stir until smooth and refrigerate. Consume daily one teaspoon of this mixture 30-40 minutes before meals, three times a day.
Self-medication can lead to serious consequences, even death!
With such a pathology, a person’s legs are constantly freezing.
- feeling of cold in the legs;
- persistent edema;
- feeling of running “goosebumps” and numbness;
- increased sweat production in the foot area;
- pallor of the skin;
- brittle nails and staining them in blue;
- weak pulse in the legs;
- cramps and pronounced pain.
Surgical treatment of obliterating endarteritis of the lower extremities is used only in severe cases and is rarely performed. Spastic nerve nodes negatively affect the course of the disease, the general condition of the patient, therefore, a surgical therapeutic method is used. Often, formations from the left and right limbs are simultaneously removed. If pronounced signs of phlebitis do not appear, then an operation is performed to replace the damaged area of the vessel with a prosthesis and bypass.
The leading symptom is intermittent claudication. These are sharp pains when walking in the calf muscles, passing during rest, which occurs already in the first stages. The more pronounced the pathological process, the less the patient can go through: first, the painless distance is 300-500 m (stage I-II), then it is reduced to 200 m or less (stage II-III), subsequently a person cannot go through 25-50 m, there are constant pains of rest, not passing after rest (stage IV).
Patients are also concerned about cooling of the extremities, fatigue and cramps in the legs, negative skin changes (“marbling”, cyanosis), fungal infections of the nails are observed, ulcerative necrotic lesions of the skin and soft tissues develop in the last stage.
The symptoms of the described diseases are similar, but there are characteristic manifestations that distinguish endarteritis from other obliterating pathologies of the arteries of the lower extremities: endarteritis develops more often in middle age, among the first signs, patients note pain at rest along with intermittent claudication, the disease is often preceded by serious infections and hypothermia of the extremities, endarteritis usually not combined with pathologies such as diabetes, hypertension, dyslipidemia.
The course of obliterating diseases of the arteries, as a rule, is long, for decades, with periods of exacerbations and remissions. A benign course is possible when changes in the arteries develop slowly, while only the arteries of one or both lower extremities are affected (with endarteritis). With a malignant course, damage to the arteries of the limbs, the abdominal aorta, coronary and cerebral arteries (with atherosclerosis) is diagnosed.
In detail about obliterating endarteritis
The disease obliterating endarteritis of the lower extremities develops and proceeds in cycles, which means that periods of weakening of serious symptoms are abruptly replaced by an exacerbated form of the disease. Often, the pathology develops in a chronic form, however, there have been cases when the disease developed very quickly.
In the early stages of the disease, the arteries are not susceptible to organic changes, in rare cases, the patient has vascular spasms. Over time, the disease obliterating endarteritis progresses and leads to the fact that the arteries partially or completely overlap. As a result, blood circulation worsens, the development of gangrene and ulcers is possible.
Stages of development
This is the first of the stages of the development of the disease, in which the blood flow is still not disturbed, but the arteries are slightly narrowed, the vessels are still normal. Clearly expressed symptoms of the disease at this stage are not observed. The patient still does not feel much discomfort from obliterating endarteritis. At this stage, diagnosing the disease is virtually impossible.
The disease develops rapidly, the load on the branches of blood vessels increases, it is this that leads to the fact that a person begins to feel the primary signs of the presence of the disease (legs quickly get tired, often freeze, lameness may occur). The bullet can still be felt. Most often, the disease is diagnosed at this stage, after which treatment is urgently needed.
Active proliferation of all layers of the walls of blood vessels begins, this entails pain when walking. Pain is present even when a person does nothing.
Symptoms of the disease increase sharply, it is very difficult to feel the pulse. This stage is already considered a neglected state.
Hair loss may be one of the symptoms of obliterating endarteritis.
At this stage of the disease, a blockage of blood vessels occurs, changes that cannot be addressed begin, tissues become dead, gangrene begins. A person can no longer move, experiencing constant pain. This stage of endarteritis is very difficult to cure, it is considered neglected. It is even more difficult to reverse the deformation of the extremities, which is why they can be amputated.
When wet, the foot swells, toxic substances begin to poison the blood and the whole body. The changes concern the entire circulatory system of the body, the vessels of the brain and heart are affected.
The exact causes of the development of obliterating endarteritis still do not exist, but the mechanism of development of this disease has long been clarified.
First, the capillaries on the legs narrow in a person, then the lumen of the vessel narrows, most often this process ends with a complete blockage of the vessel with a blood clot.
Image of clotted vessel thrombus
It is generally accepted that autoimmune processes are important in the development of this disease. The body, for unknown reasons, begins to produce antibodies that fight their own vessels.
The most common reasons for the development of the disease:
- leg injuries;
- alcohol abuse;
- improper diet (too much fatty food in the diet);
- hypothermia of the lower extremities;
- prolonged depression;
- wearing uncomfortable shoes;
Inconvenient shoes can cause illness
The smoker’s body has all the conditions for the development of the disease. Obliterating endarteritis is mainly acquired in adolescence or middle age. Smoking greatly increases the chance of getting sick.
For heavy smokers who smoke a pack or more of cigarettes per day, the risk is greatest, especially for those who smoke cigarettes. But also the risk is great when using any form of tobacco products, whether chewing tobacco or a cigar. The result of the disease is partial or complete amputation of the legs; smokers face this problem directly.
It was not possible to establish the exact nature of the development of vascular endarteritis. However, most doctors are of the opinion that they provoke the development of this pathology autoimmune antibodies that provoke inflammatory processes and affect the walls of arteries. This causes destruction of the connective tissue and narrowing of the lumen of the vessels.
Due to inflammation and sclerosis, fatty tissue that surrounds the vessels is affected. And the connective tissue begins to squeeze the arteries from the outside, which further exacerbates the existing situation.
In addition, doctors managed to find a close relationship between the development of obliterating endarteritis of blood vessels and the chronic form of poisoning of the body with nicotine and other poisons. Affect the development of the disease and frequent stressful situations, neuropsychic overstrain and even regular hypothermia of the lower extremities.
Doctors distinguish five stages of development of obliterating endarteritis of vessels of the lower extremities. Each of the stages has its own characteristics:
- The first stage is the initial one. It is impossible to detect a sign of the development of the disease at this stage. There is a gradual decrease in the lumen in the vessels and a gradual deterioration of the blood circulation process.
- The second stage is ischemic. The patient notes periodic or regular cooling of the lower extremities and the appearance of pallor of the skin. There is a feeling of weakness after a short physical exertion, soreness and lameness.
- The third stage is trophic. There is an overgrowth of connective tissue and a narrowing of the lumen of the vessels. Soreness in the legs is already more noticeable and occurs almost on an ongoing basis (not only when walking, but also in a state of calm). The pulsation becomes weaker, there is a slight deformation of the toenails.
- The fourth stage is ulcerative necrotic. There are changes in the tissues of the feet of an irreversible nature, blood flow stops. Arteries completely close, wounds and ulcers appear on the feet, tissue necrosis (death) develops. Without help, a person is no longer able to move.
- The fifth stage is the last. The formation of dry or wet gangrene occurs, and the changes apply not only to the area of the legs, but also to other organs. There is blood poisoning, general intoxication, which can trigger a fatal outcome.
In the early stages of the development of the disease, it is possible to get rid of the pathology without harming human health. Otherwise, amputation of the lower extremities and even death is possible.
The mechanism of development of obliterating endarteritis of the lower extremities is not fully understood. According to the observations of doctors, risk groups and predisposing factors that could lead to the development of the disease were identified. Very often, a combination of several causes contributes to the occurrence of obliterating vascular endarteritis.
Etiological factors that can lead to pathology:
- Psycho-emotional overstrain – frequent stresses can lead to reflex vasospasm and endarteritis;
- Bad habits – alcohol abuse, smoking and the use of other toxic substances can cause dysregulation of vascular tone and lead to vascular damage;
- Temperature differences – this mechanism is poorly studied, but practice shows that in most patients pathology develops after hypothermia of the legs with high hum >
Causes of obliterating endarteritis
For the development of a disease, a single exposure is not enough – constant contact of the patient with a causal factor that triggers the development of pathology is necessary. According to the observations of scientists, there are risk groups, the presence of which increases the risk of obliterating endarteritis:
- Male sex at the age of 20-40 years;
- Difficult working conditions, accompanied by temperature changes, frequent stress or malnutrition;
- Smokers, alcoholics, or drug users.
It does not mean at all that the disease will necessarily appear if a person approaches one or more groups. But to reduce the likelihood of risk, it is recommended to be careful about your health and follow the doctor’s recommendations.
Clinicians identify several hypotheses for the development of obliterating endarteritis:
- Neurogenic mechanism – under the influence of provoking factors, there is a violation of the functions of the nerves that innervate the vessels of the legs. Gradually, this leads to a disturbance in their functioning and the formation of spasms;
- Allergic mechanism – according to this hypothesis, own antibodies mistakenly attack the walls of blood vessels, leading to inflammation with subsequent thickening. This condition occurs with an immune disorder;
- Endocrine mechanism – characterized by impaired adrenal function, increased adrenaline production, which leads to vasospasm.
These are the three main theories that explain the development of pathology. These mechanisms are triggered by causative factors after hypothermia, malnutrition, or the ingestion of toxic substances.
Despite all the ongoing research, to date it has not been possible to find out the exact causes of the development of this disease. It is known that obliterating endarteritis of vessels of the lower extremities begins with a spasm of the arterial wall, as a result of which the lumen becomes narrow. In the future, inflammation of the walls develops and the formation of connective tissue occurs, which further disturbs the normal circulation process.
There is a hypothesis that the disease is autoimmune in nature – for some reason, the human immune system begins to produce antibodies that attack the tissues of the vascular walls, causing their inflammation. However, there is no explanation for the reasons for this malfunction of the immune system.
However, doctors were able to identify some risk factors. In particular, obliterating endarteritis of the lower extremities is much more often diagnosed in smokers. Risk factors also include atherosclerosis, infections of blood vessels and surrounding tissues, and bleeding disorders. Also, people who are subjected to frequent hypothermia are prone to this ailment. The risk of developing the disease is much higher in people who have at least once received frostbite of the lower extremities.
Of course, today there are several classification systems. Quite often, obliterating vascular endarteritis is classified depending on the stage of development. In modern medicine, it is customary to distinguish five main stages of the progression of this disease:
- At the first (initial) stage, the lumen of the vessels is narrowed, but not much, therefore, blood circulation is relatively normal. The disease practically does not cause any discomfort or visible changes, so it is extremely difficult to diagnose it at this stage – patients simply do not seek help.
- In the absence of treatment, which happens very often, the disease goes into the second, ischemic stage. The lumen of the vessels is greatly narrowed, which leads to a significant deterioration in blood supply. The pulse on the limbs can still be felt, but the patient’s condition worsens significantly. There is severe fatigue and discomfort in the legs, which causes lameness. The limb is cold to the touch. By the way, it is at this stage that the diagnosis most often occurs.
- The third, or trophic stage, is accompanied by a thorough violation of normal blood circulation. Because of this tissue, the legs do not receive enough oxygen and nutrients. The skin takes on a bluish tint, the hairs on the legs begin to fall out, and the nails break and deform. Soreness becomes more pronounced. These symptoms indicate an advanced stage of the disease, which is not so easy to cope with.
- The fourth stage is called ulcerative necrotic. At this stage, complete occlusion of the vessels of the limb is observed, as a result of which absolutely all structures of the leg suffer from a lack of nutrients and oxygen, as well as accumulation of metabolic products. The leg is cyanotic, cold to the touch, the pulse is no longer felt. The pain in the limb becomes constant – the patient can no longer move normally. Due to the violation of trophic tissue on the legs, trophic ulcers begin to form, which practically do not heal and often become a gateway for infection from the outside. The leg muscles atrophy.
- If the disease is not treated, ulcers and necrosis contribute to the development of gangrene of the extremities. Dry gangrene is accompanied by “drying” of the tissues, as a result of which the foot blackens, is deformed, the tissues begin to die. The formation of wet gangrene is possible, in which the formation and release of toxic substances into the blood is observed. In such a situation, the only possible treatment is the amputation of the affected part of the limb, as otherwise the necrosis will quickly spread to other tissues.
Obliterating endarteritis: classification and stages of the development of the disease
Obliterating endarteritis always occurs in two forms, namely: organic and generalized form. At the first, only the arteries of the legs are affected, the development of pathology is slow. In the second form, not only the vessels of the legs, but also the cerebral, as well as the coronary arteries, branches of the aortic arch can be affected.
After long studies of the disease, doctors came to the conclusion that it was necessary to divide it into classified stages, based on the data obtained on the patient’s pain defect:
- I – pain manifests itself when walking at a distance of more than 1 km;
- IIa – pain in the calf muscles is manifested in less than 500 m of the distance traveled;
- IIb – before the onset of pain, a person is able to cover a distance of 200 m;
- III – pain is present when walking even at the shortest distances and at rest;
- IV – the patient ceases to recognize his legs, they change their color, the nails deteriorate beyond recognition, ulcers appear, tissue necrosis occurs, gangrene forms.
This classification of obliterating endarteritis is not associated with the above stages of the development of the disease, and is based only on the severity of pain.
How is the diagnosis?
Endarteritis is a chronic inflammatory disease of the blood arteries that leads to circulatory disorders, and later to the complete closure of the lumen and the formation of gangrene.
Often used the term “obliterating endarteritis.” Obliteration or occlusion – impaired patency, locking the walls of blood vessels.
The most common type of disease is obliterating endarteritis of the lower extremities, mainly affecting the vessels of the feet and lower legs.
With the development of the disease, less and less oxygen enters the legs, which leads to tissue damage, disruption of normal functioning and necrosis of body parts.
Most often, this disease, as well as thromboangiitis (Buerger’s disease), which is close to it, affects middle-aged men who have such a bad habit as smoking.
Effectively, this disease is treated only in the early stages of development. In the most advanced stages, only amputation can help.
Doctors of the whole world still can not come to a common point of view about the causes of the onset of a disease in a person. Many believe that the disease has an autoimmune nature.
That is, antibodies are produced in the body that damage the walls of blood vessels. Subsequently, the walls of the vessels become inflamed.
Connective tissue forms, which narrows the gaps in the vessels and presses externally on the arteries.
The reasons for the production of such antibodies by the body, which adversely affect their own cells, have not yet been elucidated.
There are other theories about the causes of the disease:
- Nicotine allergy
- Atherosclerosis of the legs;
- Blood coagulation disorders;
- Various infections.
It is precisely known that smokers have the greatest chance of getting sick. Also, obliterating endarteritis of the lower extremities can develop after prolonged stress or with constant hypothermia of the lower extremities. In addition, those who have ever received frostbite on their feet are at risk.
With the development of the disease in patients, the following symptoms of obliterating endarteritis of the extremities are observed:
- Fatigue and heaviness in the legs even with little physical exertion or walking;
- Feeling cold in the legs;
- Swelling of the extremities;
- Sensation of “goosebumps” and numbness in the legs;
- Increased sweating in the lower extremities;
- Pallor of the skin of the legs;
- The appearance of ulcers. And later – necrosis and gangrene;
- Fragility, blueness and deformation of toenails;
- Weakening of the pulse in the lower extremities. In the later stages of the development of the disease, the pulse is not felt at all;
- Cramps and pain while moving. In the future, these symptoms appear at rest. The pain occurs in the calves of the legs, it is sharp and strong. Forces the patient to stop and wait for her. Spasms and pain during stopping pass, this allows the patient to freely go some more distance. Then the symptoms recur. This is called intermittent claudication. It is the main sign of diseases such as obliterating endarteritis and atherosclerosis.
Development of the disease
The development of obliterating endarteritis of the vessels of the lower extremities occurs gradually and cyclically. There are periods of exacerbation and periods of remission. Depending on various factors, the development of the disease can take a long time, or it can happen very quickly. The latter is observed much less frequently.
The lumen of the vessels is not much narrowed, blood circulation is still relatively normal. Symptoms of the disease are practically not observed. The patient does not feel severe discomfort. Diagnosing the disease at this stage is extremely difficult.
There is a significant deterioration in blood supply due to narrowing of the lumens. Patients have intermittent claudication, fatigue, cold feet. The pulse is still being felt. Usually the disease is diagnosed just at this stage. It is recommended that treatment be started immediately.
Due to the strong narrowing of the gaps and a long violation of the blood supply, the tissues of the legs do not receive normal nutrition in the form of oxygen and nutrients. Symptoms of the disease are aggravated.
This stage is considered a sign of a neglected disease that has not been treated or was treated incorrectly.
Almost complete occlusion of all vessels of the legs occurs. The pulse is no longer felt. Leg pain becomes permanent. The patient can no longer move, or moves with great difficulty and over short distances.
The leg muscles atrophy. Numerous ulcers appear on the legs, tissue necrosis occurs. This is a completely neglected form of the disease, which is very difficult to treat. It is even more difficult to reverse the destructive processes occurring in the limbs.
If you do nothing with ulcers and necrosis, gangrene of the feet gradually develops. Gangrene is of two types – dry and wet. With dry gangrene of the feet, the fingers or even the entire foot are dried, blacken, deform and die.
With wet gangrene of the legs, the tissues swell, toxic substances begin to be released into the blood, poisoning and infecting the whole body. In this case, only amputation of the limb helps to avoid death from blood poisoning.
Also, in the later stages of the disease, vascular occlusion can be observed throughout the body, and not just in the limbs.
It is best to diagnose obliterating endarteritis of the extremities in the early stages of the disease. A competent specialist can diagnose endarteritis as soon as possible. The faster you diagnose the disease, the faster treatment will be prescribed. So there will be more chances to significantly slow down the course of the disease.
For an accurate diagnosis, the following studies are usually performed:
- Capillaroscopy is a study of capillaries in which conclusions are made about the state of microcirculation in a particular area of the human body;
- Arteriography (angiography) – a contrast agent is injected into the artery, then the artery is X-rayed. A study is made of the state of the vessel, blood flow, and also the presence is detected and the magnitude of the pathological process is determined;
- Rheovasography – assesses the speed of blood in the vessels of the limbs and determines the level of occlusion;
- The study of skin temperature (thermography) – the temperature fields of a person reveal the presence or absence of deviations in a particular area of the body;
- Dopplerography (ultrasound) – using this procedure, the state of the tissues is assessed and it is determined how much they are changed and deformed.
In addition, the presence of suspected pathogens (viruses, fungi, infections) is detected. And also other additional analyzes are taken.
Atherosclerosis can be either one of the causes of endarteritis, or an independent disease similar to it in symptoms. Blocking blood flow in the limbs in this case is due to atherosclerotic plaques
Using differential diagnostics, doctors usually rule out symptom-like illnesses to make the only correct diagnosis. Most often, endarteritis is confused with atherosclerosis. And vice versa. Because the symptoms of obliterating endarteritis are very similar to the signs of atherosclerosis. But upon closer inspection, these two diseases are very different from each other.
The main differences between peripheral vascular atherosclerosis and endarteritis:
- The later age of onset of the disease. Atherosclerosis is mainly affected by people older than 50 years. Endarteritis also affects the younger.
- With atherosclerosis, the symptoms increase much more slowly than with endarteritis.
- With atherosclerosis, vascular lesions are symmetrical, and with endarteritis, they are asymmetric.
- Obliterating endarteritis of the lower extremities always begins with small vessels, and then goes on to large ones. Also, the disease affects the veins. Atherosclerosis begins immediately in large vessels, and does not affect the venous system at all.
- Atherosclerosis affects only the lower limbs. Endarteritis, especially in the advanced stage, affects all limbs.
It is currently impossible to completely cure endarteritis. You can only significantly slow down the rate of development of the disease and alleviate the symptoms.
There is no special diet for patients with endarteritis. You just need to eat right, not overeat and give up alcohol. It is also imperative to quit smoking and begin to move a lot.
After diagnosing the disease, it is necessary to immediately begin treatment of endarteritis. First of all, a specialist prescribes drugs. Physiotherapeutic methods and treatment with folk remedies are also successfully applied. In extreme cases, surgery is performed.
Drug treatment includes:
- Antispasmodic drugs;
- Vitamins The most useful for this disease – PP, B, C, E;
- Blood-thinning drugs;
To improve blood circulation in the limbs, the following physiotherapy is performed:
- Various thermal treatments. Sauna, heating, ozokerite applications and others;
- Baromassage. Placement of legs in a pressure chamber with the influence of either increased or decreased pressure alternately;
- Various bathtubs (hot, contrasting, mustard, coniferous, etc.);
- Diadynamic currents;
- Magnetotherapy. Treatment with a high-frequency magnetic field.
If drug treatment in combination with physiotherapy does not help or give a weak effect, then a surgical operation is prescribed.
Depending on the extent of the affected area, shunting may be necessary (creating an additional path for blood circulation to bypass the damaged part of the vessel using shunts), removing part of the artery or completely replacing the artery with a prosthesis.
In addition, the patient may need to have thrombintimectomy. This is the removal of a blood clot that blocks the path in the artery.
The most extreme measure is limb amputation. It is used only if the patient’s life is threatened.
Endarteritis is a very serious disease. In no case should you self-medicate. All procedures and medications should be taken under the strict supervision of a qualified professional. It is strictly not recommended to start treatment.
Folk remedies can help only in the very early stages of the disease. It is best to use them in combination with medical medicines prescribed by a specialist.
Diagnosis of pathology is possible with the help of ultrasound.
A favorable prognosis awaits patients who comply with the doctor’s recommendations when conducting preventive measures. Most important is compliance with the following rules:
- Give up bad habits;
- Observe the diet, do not eat fatty and spicy foods;
- Lead a mobile lifestyle – moderate physical activity is always beneficial for the vessels of the legs;
- Avoid hypothermia;
- If you suffer from excess weight – it is recommended to take measures for weight loss.
The essence of the main prevention is to strengthen the arteries of the legs, preventing the effects of causative factors that contribute to the occurrence of pathology.
Obliterating endarteritis is a serious disease that leads to persistent impairment of blood flow in the vessels of the lower extremities. The disease cannot be cured – but if timely treatment is carried out, you can live your whole life without the manifestation of the main signs of pathology. If the patient does not carry out prophylaxis and does not follow the doctor’s recommendations, the prognosis is poor, complications in the form of gangrene may develop.
A person must exclude smoking from life, which is the main predisposing factor for the development of the disease. It is worth eating properly, avoiding frostbite and prolonged exposure to too hot or cold rooms. Prevention of obliterating endarteritis includes regular exercise and wearing comfortable shoes.
By observing the following rules and recommendations, you can significantly reduce the risk of developing obliterating endarteritis of the vessels of the lower extremities.
First, give up smoking, alcohol and other bad habits. They adversely affect the body as a whole, causing this kind of serious pathology. Secondly, avoid hypothermia and frostbite of the legs. To do this, use warm natural socks made of sheep, goat or rabbit wool, as well as comfortable, high-quality shoes for the season.
If possible, try to minimize leg injuries, and be sure to monitor the hygiene of the lower extremities, paying particular attention to this issue. Pay attention to your diet, in the diet of which there should be no fatty, salty, spicy dishes and products. Try to refuse sweets and fast food, preferring natural and wholesome food.
In case of excess weight or even obesity, try to get rid of this problem. Since it adversely affects not only the condition of the legs, but also the whole organism. And go in for sports. The lower extremities need moderate physical activity for normal, healthy functioning. Try to walk for at least half an hour at least daily. Believe me, this will positively affect not only your figure and condition of your legs, but also on the whole body.
Take care of yourself, and pay attention even to minor symptoms. This will allow timely detection of obliterating endarteritis, which will give a much greater chance of recovery without compromising health.
It is established that the triggers of a long spastic condition of peripheral vessels are smoking, chronic intoxication, cooling and frostbite of the extremities, a disorder of peripheral innervation due to chronic neuritis of the sciatic nerve, and limb injury. According to some reports, the occurrence of obliterating endarteritis can be caused by typhus, syphilis and epidermophytosis of the feet.
An important role in the development of obliterating endarteritis belongs to neuropsychic factors, disruption of the adrenal glands and gonads, which provokes vasospastic reactions. The autoimmune mechanism of obliterating endarteritis is indicated by the appearance of antibodies to vascular endothelium, an increase in the circulating immune complex and a decrease in the number of lymphocytes.
- The clinical course of obliterating endarteritis includes 4 stages:
- trophic disorders;
- ulcerative necrotic;
The ischemic stage is characterized by the appearance of a feeling of fatigue, coldness in the lower extremities, paresthesias, numbness of the fingers and cramps in the feet and calf muscles.
Sometimes at the initial stage of the pathology in patients, the phenomena of migrating thrombophlebitis occurring, with the formation of blood clots in the saphenous veins of the legs and feet.
In trophic disorders, an increase in all of the above phenomena is noted, pains in the limbs during walking, and intermittent claudication occurs. The pains are localized in the muscles of the leg, in the area of the soles or toes.
The skin of the legs acquires a marble color or blueness, it becomes dry, a slowdown in the growth of nails and their deformation is detected, hair loss occurs on the legs.
Ripple in the arteries of the feet is practically not detected or absent on one leg.
The ulcerative-necrotic stage is characterized by the appearance of pain at rest, atrophy of the muscles of the legs, swelling of the skin, the formation of trophic ulcers on the feet and fingers. In most cases, the ulcerative process is aggravated by the development of lymphangitis or thrombophlebitis. Arterial pulsation is not detected on the feet.
Gangrenous stage is characterized by the development of dry or wet gangrene on the lower extremities. Most often, the onset of gangrene is preceded by an injury to a limb or an existing ulcer. In most cases, lesions of the feet and fingers are detected, less often gangrene – lower leg tissues. The toxemia syndrome resulting from gangrene becomes the reason for the need for amputation of the limb.
Diagnosis of obliterating endarteritis occurs through a number of functional tests – Goldflam, Shamova, Samuelsa and a thermometric test. The characteristic symptoms of the pathology are also examined: Opel plantar ischemia symptom, finger pressure symptom, Panchenko’s knee phenomenon, which allow us to identify insufficiency of arterial blood supply to the limb.
To confirm the diagnosis, the patient will need the appointment of ultrasound dopplerography of the vessels of the lower extremities, rheovasography, thermography, capillaroscopy, oscillography, angiography of the lower extremities.
Conservative therapy is effective only in the early stages of obliterating endarteritis.
The treatment is aimed at relieving spasm of the vascular wall, stopping the inflammatory process, preventing thrombosis and improving microcirculation.
Surgical treatment is indicated for ulcerative necrotic stage of obliterating endarteritis, pain at rest, severe intermittent claudication
Prevention of the development of obliterating endarteritis is based on the elimination of provoking factors, the exclusion of limb injuries and the regular conduct of courses of drug therapy for vascular pathologies.
Physiotherapy for Endarteritis
Physiotherapeutic procedures help patients improve blood circulation in the lower extremities.
- One of such methods of treating the disease is thermal procedures, for example, sauna, diathermy, warming the lower back with the help of UHF, Bernard currents.
- Barotherapy or baromassage – the injured limb is released into the pressure chamber, where it is alternately affected by pressure.
- Ultrasound treatment
- Magnetotherapy – treatment is carried out by a high-frequency magnetic field.
- Electrophoresis – a drug is injected directly into the desired area under the influence of electric fields.
Treatment of obliterating endarteritis with water procedures – coniferous, radon baths. There is a large variety of foot baths.
- Mustard baths – ordinary foot baths, with the addition of dry mustard powder (2 tablespoons).
- Hot bath – water is heated to 43–45 degrees, feet need to soar for about 20 minutes. After the procedure, it is recommended to wear warm wool socks.
- Contrast baths – limbs are dipped in hot water for 5 minutes, then sharply in cold water for half a minute. Repeat the procedure 4 times. The last 5th time must be completed by immersing the feet in hot water for 1 minute. Wipe your feet. Wear woolen socks.
Nutrition for Endarteritis
As already mentioned, a special diet for patients with obliterating endarteritis simply does not exist. But there are a lot of other diets, with which you can bring your body into tone, get rid of excess weight. To do this, you need to eat low-calorie foods, and spend more calories than you consume.
It is recommended that patients remove all foods from the diet, the content of vitamin B in their composition:
Mountain ash is very useful – strengthens the vascular system.
Endarteritis and atherosclerosis
Some patients confuse both of these diseases – considering them synonymous with one pathologist, but this is not so. Both diseases have one similarity – they contribute to obliteration, disrupting the patency of the arteries with the subsequent development of insufficient blood supply. But there are differences, which are as follows:
- Atherosclerosis obliterans – characterized by systemic lesions of arteries of predominantly large caliber, deposition of atherosclerotic plaques on their walls, narrowing of the lumen and impaired circulation. This disease affects not only the vessels of the limbs, but also the whole organism, it equally occurs in both men and women over the age of 40;
- Obliterating endarteritis – no deposits occur on the walls of blood vessels, as with atherosclerosis. The inner shell is affected – spasm, inflammation is formed, the epithelium thickens. The disease mainly affects the small arteries of the extremities; in 99% of cases it develops in men under 40 years of age.
Stage III: pains of a constant nature, can appear not only in the legs, but also in the buttocks and lower back, intermittent claudication after 100 meters of walking, coldness of the feet in any weather, progressive fungal diseases of the nails, the skin of the legs acquires a bluish tint.
Stage IV: severe pain at rest, intermittent claudication after walking at short distances of 100-50 m, ulcerative necrotic processes, gangrene develop.
With atherosclerosis, the situation is significantly complicated by the generality of the pathological process, in which all the arteries of the body are affected. Elderly patients suffer from atherosclerosis-associated pathologies of various organs (cerebral arteries), the quality of life and the prognosis of the disease depend mainly on timely and competent medical care.
Since obliterating diseases of the arteries of the legs at the initial stages can be almost asymptomatic, or patients do not correlate the unpleasant manifestations with diseases of the vessels of the legs, a visit to the doctor is late, when the symptoms are already pronounced and change the entire routine of life. A careful attitude to health and a timely visit to a doctor (surgeon, vascular surgeon) will allow you to take control of the disease, maintain activity and avoid serious complications.
Are there effective preventative measures?
In order to prevent the disease, you need to quit all bad habits, lead a healthy and active lifestyle. According to doctors, among patients with endarteritis there are almost no non-smoking patients. Nicotine leads to a narrowing of blood vessels, slows down the movement of blood and increases its coagulability.
If the patient was diagnosed with obliterating endarteritis at an early stage, the following requirements must be observed:
- wear comfortable quality shoes;
- beware of limb injuries;
- Healthy food;
- It is strictly forbidden to supercool the legs, create the most comfortable temperature conditions;
- observe foot hygiene, regularly wash feet with soap 2 times a day, use nutritious creams.
Obliterating endarteritis is a disease that is not worth joking with; it requires proper and timely treatment. At the first signs, disturbing conditions, cramps and cramps, you need to immediately consult a doctor for examination.
Treatment of obliterating endarteritis of the lower extremities is a long and difficult process. And even with the use of all means of modern medicine, there are no guarantees for the successful elimination of the disease in the early stages. It is much easier to try to prevent the onset or relapse of the disease. Of course, drugs that can protect a person do not exist. Nevertheless, compliance with some simple rules significantly reduces the risk of developing such a serious ailment.
- To begin with, it is worth giving up smoking, alcohol and other bad habits, since all of them to one degree or another affect the state of the vessels. This point is especially important for smokers, since the substances contained in the cigarette cause a small spasm of the vessels.
- It is necessary to adjust the diet, removing from it too fatty, too spicy and salty foods.
- Positive impact on the state of the body and, in particular, blood vessels, affect sports. Doctors recommend light running, swimming, cycling, long walks.
- It is important to remove excess weight, which creates additional stress on the legs.
- It is necessary to try to maintain the most comfortable temperature regime – the legs should neither be too cold or too hot. In winter, you need to dress according to the weather (do not wear skirts with thin tights at low temperatures), and also do not abuse tanning salons, saunas and baths.
- It is important to adhere to the rules of hygiene, care for the skin of the legs, if necessary, treat it with protective or moisturizing creams.
- Be sure to choose comfortable shoes made from natural fabrics that will not squeeze the foot and allow the skin to “breathe”. Of course, it is better to prefer comfortable shoes with a low stable heel to high stilettos.
If you are at risk, regularly undergo medical examinations – the disease is much easier to cure if it was diagnosed at an early stage.
How does pathology develop?
Usually the disease proceeds gradually, at the first manifestations of the symptoms, the vessels are spasmodic slightly, and the blood flows through the bypass (collateral) arteries. Under the microscope, you can see the following changes:
Dystrophy of the nerves and inner lining of the vessel. In this case, the symptoms do not appear, since blood circulation is prov >
Pathological processes in the vessels with obliterating endarteritis
Classification of obliterating endarteritis includes the prevalence of pathology in the body and its severity. In the first case, two types of disease are distinguished:
- Generalized endarteritis – the disease affects the small vessels of the whole body, leading to systemic disorders;
- A limited version of the pathology – the arteries of the limbs are damaged, only local symptoms appear.
According to the severity, the obliterating spasm of the vessels is divided into four degrees:
- I – discomfort and pain in the legs appear when walking for 1 km;
- II – distinguish yes class: I A – symptoms appear when walking from 200 m to 1 km and I B – soreness worries after overcoming distances of less than two hundred meters;
- III – signs occur with small loads and at rest, the external manifestations of the disease are moderate;
- IV – the formation of ulcers and gangrene.
When a diagnosis is made, a stage of pathology is set out, talking about the progression of damage to the vessel wall and the nature of the complications.
Symptoms of obliterating endarteritis occur gradually when collateral vessels do not cope with their function. As a result, hypoxia develops – a lack of oxygen, which manifests itself as a gradual weakness and soreness in the legs. Over time, limb tissues begin to die, which contributes to the manifestation of various symptoms.
The main signs of endarteritis:
- Increased fatigue in the legs – develops in the initial stages, indicates a lack of blood flow to the limbs;
- Loss of sensitivity – occurs against the background of ischemia. At the beginning of the patient, discomfort in the fingers is disturbed, which eventually rises. Later, “goosebumps” appear on the skin and a decrease in perception of sensitivity in the legs;
- Pallor of the skin is the main diagnostic sign for the doctor, talking about the insufficiency of arterial blood flow;
- Edema – in the absence of therapy, obliterating endarteritis passes into an advanced stage, the first sign of which is swelling of the limb;
- Fragility of nails – with prolonged ischemia, oxygen starvation develops, leading to deformation and fragility of the nail plates;
- Cramps in the extremities are the main symptom of obliterating endarteritis. The symptom is concentrated in the calf muscles, at the initial stages it manifests itself with prolonged exertion, then with short walking, complicated by lameness;
- Weakening of the pulse on the legs – develops at the finale, speaks of a strong narrowing of the lumen of the vessel;
- Tissue death – if blood flow is not restored, ulcers appear that hurt and bleed. After cell death, dry or wet gangrene forms.
These symptoms occur as obliterating endarteritis progresses – the more the lumen of the vessel closes, the more pronounced ischemia and local symptoms are.
Symptoms of the development of obliterating endarteritis
Diagnosis of obliterating lesions of blood vessels is based on examination of the patient and laboratory and instrumental methods of research. An external examination of the patient’s legs or analysis of the photo of obliterating endarteritis pallor of the skin, sometimes – bluish color of the fingertips and nail plates. With a severe form of pathology, there are scattered bleeding ulcers in the lower parts of the leg, darkening of the skin (gangrene).
To confirm the diagnosis, the following examination methods are prescribed:
- Dopplerography – shows the state of the vascular wall;
- Rheovasography – registers blood flow velocity;
- Capillaroscopy – prov >
Diagnostic methods for obliterating endarteritis
When the patient has been examined and the degree of vascular damage has been identified, the doctor draws up a program that details how to treat obliterating endarteritis of the lower extremities.