Cardiovascular system >>>> Obliterating endarteritis threatens with the loss of the lower limbs

Obliterating endarteritis threatens with the loss of the lower limbs.

Endarteritis, or more correctly, obliterating endarteritis (synonym: Buerger disease) is a progressive, cyclically developing disease of the peripheral vascular system (arteries and superficial veins) associated with degenerative changes in the tissue of the vascular wall, leading to vascular stenosis (narrowing of their lumen), obliteration vessels (complete closure of the vessel lumen), followed by impaired blood flow and the development of gangrene.

According to statistics, obliterating endarteritis develops in men tenfold more often than in women. The disease can make itself felt as early as the age of 20, but most of the recorded cases of this disease occur at the age of 30-40 years and later. The etiology of the disease (the causes of endarteritis) is not fully understood, but there are several theories that the causes of the development of the disease are of an autoimmune nature. A direct relationship was also found for the development of the disease in the presence of a group of factors:

Alcohol abuse,
Smoking,
Prolonged stress and nervous tension,
Frequent hypothermia of the lower extremities,
Generalized infections,
Vascular diseases,
Hypersensitivity of blood vessels to adrenal hormones,
Frequent injuries of the lower extremities,
Avitaminosis .

Most often, the disease affects the vessels of the lower extremities, developing cyclically, firstly leads to insufficient blood circulation in the peripheral vessels of the lower extremities, then to the development of ulcers, tissue necrosis and gangrene.

Endarteritis signs:

Periodic sensations of cold extremities,
Decreased sensitivity in the toes, feet,
Feeling of numbness in the limbs , tingling sensation,
Cramps in the calf muscle or foot,
Pain when walking (the so-called intermittent claudication develops) and pain at rest,
Swelling of the tissues of the lower extremities,
Pain in the gastrocnemius muscle, spreading along the direction of the blood vessels,
Changes in the structure and color of the nail plate on the toes (turns blue, begins to crumble).

In the process of development of the disease, the condition of the skin in the lower extremities changes: trophic changes appear in the form of thinning of the skin over the vessels, changes in its color from cream to shades of blue. Ulcers appear, which either take a long time to heal or do not heal at all.

In order to diagnose the disease, laboratory tests of the blood composition and the state of the vessels (lymphocytogram, coagulogram, thrombocytogram) are carried out. The state of the vascular wall is examined using angiography, volumetric sphygmography (measures the pulsation of the arteries) and MRI. When diagnosing endarteritis, differential diagnosis is carried out with diseases that cause vascular damage - diabetes mellitus and atherosclerosis.

Due to the fact that with endarteritis there is a fibrotic change in the tissues of the vascular wall, which is irreversible, then in the treatment of obliterating endarteritis, the goal is set: to achieve long-term remission of the disease, thereby slowing down the processes of degradation of vascular tissue.

Treatment for endarteritis includes:

Getting rid of bad habits,
If you are overweight, reduce it so as not to create additional stress on the legs,
Changing the type of activity, if it is associated with work while standing,
Regular exercise, forcing a lot of movement on your feet,
Pay more attention to foot hygiene, do baths, treat with cream,
Wear comfortable, soft shoes that do not pinch your foot,
Wear warm underwear and warm socks during the cold season.

Drug therapy for endarteritis is based on the intake of vasodilators, antispasmodics, anticoagulants, drugs that improve the rheological characteristics of blood (reduce the aggregation and adhesion of platelets and / or erythrocytes), anti-inflammatory and antihistamines, ganglion blockers, vitamins. In some cases, immunosuppressive therapy is performed.

You can use physiotherapy treatment: hyperbaric oxygenation, Bernard currents, UHF.

Surgical treatment of endarteritis is prescribed in case of growing negative symptoms, deterioration of the patient's condition. Surgical treatment can include several different procedures, depending on what the goal is:

to bypass the damaged section of the vessel, an anastomosis is created - a bypass procedure,
to improve the blood supply to the extremities, resection of the second and third lumbar ganglia in the sympathetic trunk of the autonomic nervous system - a sympathectomy procedure ,
remove blood clots that block the lumen of blood vessels - thrombintimectomy procedure.

The least desirable procedure for amputation of a part of a limb is performed when the disease has reached the stage of extensive tissue necrosis or gangrene. It is designed to keep the patient alive.