Angiopathies are a group of pathologies associated with damage to vascular structures and deterioration of blood circulation. The development of the disease occurs gradually: the arteries and veins lose their tone, the gaps inside them narrow. As a result, the organs experience nutritional deficiency. Angiopathy of the lower extremities is diagnosed mainly in patients with diabetes mellitus. Lack of adequate therapy can lead to amputation and even death. In order to avoid such complications, it is necessary to know what symptoms accompany the pathology and when to see a doctor.
Angiopathy - a symptom or a disease?
Almost all vessels in the human body can be subject to pathological changes. Of particular interest is the defeat of the microcirculatory structure, which is represented by many plexuses. Speaking of angiopathy, most often they mean the pathology of the lower extremities. With this diagnosiseven absolutely he althy people have to face. Why is this happening? This phenomenon can be explained by the lack of understanding between different specialists and overly impressionable patients. The latter, having heard an unknown diagnosis, immediately panic.
It must be clearly understood that the described deviations cannot be an independent disease. Angiopathy is a manifestation or complication of certain functional disorders in the body. In its essence lies a decrease in elasticity and a decrease in the lumen of blood vessels. As a result, symptoms of circulatory disorders in the tissues appear. Such a clinical picture is characteristic of a lesion of the muscular layer of the vascular wall or a change in its innervation. In this case, a spasm occurs with a simultaneous slowdown in blood flow.
Main causes of angiopathy
Doctors identify a number of factors that contribute to the emergence of the pathological process. Diabetes ranks first among them. Angiopathy of the lower extremities in 70% of cases develops against the background of excess blood sugar. The second place belongs to hypertension. With severe symptoms of the disease, the arteries and capillaries cease to cope with the functions assigned to them. Gradually, the walls of the vessels become covered with fat, the blood becomes thicker. Together, these factors provoke the development of angiopathy.
Among other causes of the pathological process can be noted:
- smoking;
- working with toxic materials;
- hypotension;
- congenitaldisorders in the circulatory system;
- hereditary predisposition.
Treatment of angiopathy depends on the timeliness of the diagnosis. That is why it is important to be able to recognize the signs of illness at an early stage.
What forms does angiopathy of the lower extremities have?
ICD-10 (International Classification of Diseases) assigned code 179.2 to this pathology. In its course, it is customary to distinguish two forms:
- Microangiopathy (damage to small vascular formations). Often associated with retinal dysfunction, renal blood flow disorder.
- Macroangiopathy (damage to arterial structures of medium and large caliber). This violation is typical only for the vessels of the extremities.
Each form of the pathological process has a specific clinical picture.
Microangiopathy symptoms
At the initial stage, microangiopathy of the lower extremities practically does not manifest itself. However, when examining the vessels, certain changes are already detected in them, which eventually begin to cause discomfort. The skin becomes pale and cold to the touch. Small sores appear on the legs, which spread very quickly to new areas. The patient may be disturbed by discomfort, pain after physical exertion. Around the sores, the skin acquires a reddish tint, swelling. The penetration of the pathological process into muscle or bone tissue is accompanied by the appearance of phlegmon. Necrotic areas gradually go beyondulcers spreading to the fingers. If the entire foot is affected, the only option to save the leg is to amputate part of it.
Macroangiopathy symptoms
The development of pathology also occurs gradually. At first, patients complain of stiffness in the legs in the morning. Then the discomfort does not disappear throughout the day and is complemented by numbness in the fingers. Feet are constantly cold, sometimes there is intermittent lameness. The skin becomes pale. Intermittent claudication becomes more pronounced day by day. To all the symptoms are added severe pain in the legs, cramps. Unpleasant sensations (burning, tingling) do not leave the patient even during rest. Later, edema and sores appear with signs of necrosis. All new areas are gradually involved in the pathological process. Macroangiopathy of the lower extremities is often accompanied by fever, general weakness.
How dangerous is angiopathy in diabetes mellitus?
Pathological changes in the vessels of the extremities are a frequent companion of patients with diabetes mellitus. Atrophy and circulatory disorders in the foot are a consequence of the loss of capillary capacity. Excess sugar in the blood gradually destroys the walls of blood vessels. In some parts they become thinner, in others they thicken. As a result, the lumen of the vessels narrows, and the tissues die against the background of oxygen starvation. As the disease develops, the fingers atrophy first, then the entire foot, lower leg and thigh. Affected structures require immediate amputation, as they developgangrenous processes. In this case, there is often a preservation of pulsation in the limbs.
Diabetic angiopathy of the lower extremities is the most severe complication faced by patients with insulin deficiency in the blood. Its prevention is recommended immediately after the diagnosis is confirmed.
Modern diagnostic methods
When an angiopathy of the lower extremities is suspected, the first step in the diagnosis is to take a patient history and examine the affected areas. After that, they proceed to laboratory research using high-tech devices:
- MRI. Allows you to evaluate the structure of soft tissues.
- Ultrasound. Doppler study helps to determine the state of the walls of blood vessels, and duplex scanning - the speed of blood flow.
- Angiography. X-ray diagnostics using a contrast agent allows you to visualize the patency of blood vessels.
- CT. Used to study pathological areas of the limbs.
The use of the above diagnostic methods is necessary to obtain a general picture of the pathological process, to assess the degree of vascular damage. Examination of the patient also allows you to determine what form angiopathy of the lower extremities belongs to.
Treatment: medical and surgical
Methods of treatment of angiopathy depend on the causes that provoked its appearance. In the early stages, sometimes even simple nutritional adjustmentsand lifestyle leads to a slowdown in the pathological process. What other treatment options are there?
- Drug therapy. Patients diagnosed with "angiopathy of the lower extremities" are prescribed drugs to improve vascular tone and normalize pressure. It is also recommended to take medications that stimulate blood circulation processes (Actovegin, Aescusan, Heparin). All medicines are selected individually, taking into account the overall clinical picture of the disease.
- Lymph modulation. Carrying out special procedures improves the circulation of blood and lymph in the body, the rapid removal of metabolic products. After several treatment sessions, the swelling of the skin in the affected areas noticeably decreases.
- Operation. Surgical intervention implies the plasticity of tissues and the reconstruction of altered vessels. In especially serious cases, when the necrotic process has spread to the entire foot, amputation is indicated.
Timely access to a doctor allows you to stop the course of the pathological process and avoid surgical intervention. Sad statistics show that in 10% of cases, blood poisoning leads to death.
Treatment with folk remedies
Traditional healers offer their recipes for the treatment of such an ailment as angiopathy of the lower extremities. Symptoms and manifestations of the pathological process at the initial stage usually do not cause inconvenience. If they are recognized in a timely manner, it is possible to warnfurther progression of vascular disorders. It should be noted that the treatment of folk remedies must be combined with traditional methods.
Healers suggest using plants in treatment that help normalize metabolism. These are ginseng, Manchurian aralia, safflower leuzea and others. These plants can be used to make decoctions and tinctures. To improve carbohydrate metabolism, doctors recommend adding medicinal dandelion leaves and elecampane to tea. Coffee is better to replace with chicory. It must be dried, roasted and ground. The leaves of the plant can be used in salad dressings.
Treatment of angiopathy in diabetes mellitus
Earlier, we have already told what symptoms accompany angiopathy of the lower extremities. In diabetes mellitus, treatment practically does not differ from that in the case of other causes of the pathological process. The basis of drug therapy is drugs that improve blood clotting. Glucose levels are regulated by the administration of insulin. An additional therapeutic effect is given by physiotherapy. For example, mud therapy and plasmapheresis can purify the blood.
In advanced cases, they resort to surgical intervention. At the initial stage of pathology development, lumbar sympathectomy is used. Reconstructive surgeries also have a positive effect, thanks to which it is possible to normalize microcirculation. The neglected angiopathy of the arteries of the lower extremities, accompanied by gangrene, requires amputation. After a course of rehabilitation, the patient is madehigh quality prosthesis.
Prevention measures
In diabetes or hypertension, angiopathy prevention should be started immediately after the diagnosis is confirmed. To do this, it is recommended to periodically take tests and undergo a medical examination. It is important to constantly monitor blood sugar, monitor blood pressure and the condition of the veins. Diabetic angiopathy of the vessels of the lower extremities requires immediate treatment when the first symptoms of the disease appear. The course of therapy should be prescribed by a doctor.
In addition, the prevention of pathological changes in blood vessels includes the following activities:
- quitting smoking and other addictions;
- doing feasible sports;
- strengthening immunity and central nervous system;
- rational nutrition;
- fight overweight.
The most important thing is a positive attitude. It is he who, as a rule, has a decisive influence on the recovery process.
