Peripheral arterial blockage treatment

vascular surgeon

What are the causes of blockage of the arteries and the ways of treatment?
Before explaining the methods of treating leg artery blockage, it is necessary to understand the causes of that occlusion.

Peripheral arterial disease (PAD) is a condition that affects the blood vessels and prevents them from performing their full function, as the arteries lose their elasticity and ability to pump blood to the extremities. If leg arteries are blocked, blood and oxygen supply to the legs decreases. This condition is known as atherosclerosis.

Atherosclerosis means the accumulation of fatty substances on the inner walls of the artery in a way that leads to its narrowing or blockage, which affects the blood supply to the feet, causing many health problems.

Causes of leg arteries blockage:
Smoking: The nicotine and carbon monoxide in cigarettes damage the inner lining of the artery, which increases the chance of fat deposition to the artery wall and causes atherosclerosis.
Diabetes and hypertension: Hypertension and failure to maintain the normal range of blood glucose levels in diabetic patients cause peripheral arterial blockage.
Age: The risk of peripheral arterial occlusion increases in patients over 50 years old.
Obesity: If a person is overweight, with a body mass index of more than 30. BMI is an assessment of the degree of obesity that the patient may experience, and it is the result of dividing the weight in kilograms by the square of the height in meters.
Genetic causes: The presence of a family history of PAD often causes blockage of the arteries in the foot.
Hypercholesterolemia: It occurs as a result of eating unhealthy and high-fat foods.
Lack of movement.

Symptoms of clogged arteries in the leg: 
One of the most obvious symptoms of arterial blockage in the leg is that the patient feels pain in the feet while walking for long periods and disappears after stopping for a few minutes to rest. The patient also suffers from leg convulsions upon walking or climbing the stairs. Also, the patient may feel pain at rest times. The pain may prevent him from sleeping.

Symptoms of blocked arteries in the leg also include:
- Cool skin on the feet.
- Feet and legs injuries with difficulty in healing.
- The presence of shining skin on the feet and legs.
- Skin color change.
- The slow growth of toenails.
- Foot hair loss.
If the patient feels the symptoms of blocked arteries in the leg, he should quickly refer to an experienced specialist for treatment.

Peripheral arterial disease diagnosis:
For the diagnosis of peripheral arterial disease, Dr. Waleed El-Daly, assistant professor of vascular surgery and diabetic foot, relies on examining the patient, knowing his medical history, and performing several tests and examinations that confirm the incidence of PAD or blockage. According to the results, He decides whether the patient needs a surgical intervention or medical treatment, and among those tests are:

- Ankle/brachial index (ABI) compares the blood pressure of the lower limbs with that of the upper limbs. In the case of lower blood pressure in the lower limbs than in the upper limbs, this is evidence that the patient suffers from PAD.
- Arterial Doppler Ultrasound provides detailed information about the extent of blood flow. 
- Angiography is a type of X-ray used to check blood vessels through a special dye to reflect blood flow and detect blockages.
- CT or MRI scan.

What are the best ways to treat blocked arteries in the leg?
Treatment methods vary according to whether the patient's condition is advanced or simple. In general, the treatment aims to achieve two main goals:
1. Reducing aggravation of the symptoms such as leg pain.
2. Stop the development of atherosclerosis to reduce the risk of heart attack or stroke.

First: Pharmacotherapy:
If you have signs or symptoms of occlusive arterial disease, you will likely need drug therapy. Dr. Waleed El-Daly may prescribe the following:
Anti-platelet drugs, such as aspirin or clopidogrel, prevent blood clots and thus reduce the risk of heart attacks or strokes.
Antihypertensive drugs.
Antihypercholesterolemic drugs.
Medicines that improve blood circulation.
Pain-relieving drugs.
Antidiabetic drugs for diabetic patients.

Second: Interventional procedures:
1- Unblocking the arteries of the leg with catheterization: 
Some doctors consider catheterization as the best way to treat arterial blockages and are used to improve blood flow in the artery. Dr. Waleed El-Daly, assistant professor of vascular surgery and diabetic foot treatment at Cairo University, inserts a catheter in the blocked artery and inflates a small balloon to reopen the blocked artery again. A stent may also be inserted to maintain the blood flow. This method of treatment cures more than 90% of peripheral arterial occlusions.

Steps for catheterization of the leg arteries:
1- The doctor will anesthetize the patient to avoid pain.
2- A small incision, not exceeding 1 mm, is used to insert a catheter through the skin and pass it until it reaches the place of the blockage, based on X-rays. 
3- The patient is injected with a specific substance to help show the blood vessel on a special screen, which allows the doctor to locate the blockage.
4- Then the balloon fixed in the catheter is inflated for a short period to open the blocked artery.
5- Some cases need to install a stent, approved by the FDA, to keep the artery open and support it. Medication is released slowly from the stent to help keep blood vessels patent.

After catheterization:
Several cautions must be followed after the procedure, including:
- Care not to move for the first 12 hours after undergoing catheterization.
- Perform life activities normally the day after the procedure.
- Stop smoking completely.
- Regular follow-up every 6 months is preferred.

2- Peripheral artery bypass surgery:
The doctor may go for a traditional surgical procedure to deal with 10% of cases of peripheral artery blockage, where he performs a bypass surgery to bypass the blocked artery through another artery or an artificial one, allowing blood to flow and bypass the occluded artery.

Dr. Waleed El-Daly, the best vascular doctor, uses the latest advanced medical methods to ensure the best way to treat blockage of the arteries in the leg and choose the most appropriate for the patient to end his annoying symptoms.