This brochure provides a general overview of the symptoms and treatment options for PAD. Please be aware that your individual situation may differ from what is described.WHAT ARE WINDOW LEGS?You have been diagnosed with an abnormality in one of the arteries to or in your legs. This abnormality is caused by fatty deposits in the arterial wall and calcification of the arterial wall. Atherosclerosis usually leads to narrowing or even complete blockage of the artery. For more information, see the brochure on arterial disease .
During exertion (walking, running, climbing stairs), the leg muscles require significantly more blood and oxygen than at rest. Narrowing or blockage of an artery to or in the legs results in reduced blood flow. This leads to an insufficient blood supply, and thus an insufficient oxygen supply, to the legs. A lack of oxygen leads to muscle acidification, which causes cramping pain. As a result, you may experience pain in your calf after walking a short distance. After a short rest, the pain subsides, and you can walk a short distance again. This is called intermittent claudication, or window shopping legs, because stopping to walk gives the impression that you are looking into shop windows.WHAT ARE THE COMPLAINTS OF VASCULAR NEUTRALISATION IN THE LEGS?Pain while walking is the main symptom of intermittent claudication. The location of the pain indicates the location of the narrowing in the blood vessels. The narrowing in the blood vessel is always above the level where the pain occurs. If pain occurs in the buttocks and thigh while walking, the narrowing is in the iliac artery located above it. If you experience pain in the calf while walking, the narrowing is in the femoral artery. If a narrowing in one of the three lower leg arteries occurs, the pain is in the foot. The pain can limit your daily activities, such as at work, during household chores, or during sports.
Other symptoms of a narrowing may include cold feet, hair loss on the legs, thickened toenails (often due to a fungal infection), and delayed nail growth. Due to poorer circulation, your leg may turn pale when lifted and red when lowered.
In more advanced stages of vasoconstriction or even occlusion of the leg arteries, the lack of blood in your leg can occur even at rest, without muscle activity. This can cause pain even at night in bed. Wounds on the legs can also heal poorly or even develop spontaneously.TREATMENT OF VASCULAR OCCLUSIONS IN THE LEGSDepending on the severity of the situation and which artery is affected, there are several options:
- Conservative treatment
- Angioplasty
- Surgical treatment
Conservative treatment (walking training)
The treatment of claudication primarily focuses on limiting existing risk factors for atherosclerosis: not smoking, healthy eating, and sufficient exercise. High blood pressure, diabetes, and high cholesterol can be treated with medication. Smoking is a risk factor you can control yourself.
Intensive walking training is also part of this approach. By walking frequently and gradually increasing the distance, your symptoms can eventually decrease or even disappear completely.
Angioplasty
Sometimes the narrowing is such that it must be determined whether it is possible to stretch the blood vessel at the site of the narrowing using a balloon. This makes the blood vessel more patency possible again. In the Netherlands, this procedure is called "angioplasty" after its inventor. It is a minimally invasive procedure that can sometimes be performed on an outpatient basis (for more information, see the "Angioplasty " brochure ).
Before a narrowing can be angioplasty, the affected blood vessel must first be assessed by means of a vascular examination with contrast (angiography). The narrowing can be treated directly using the same examination.
Surgical treatment:
Due to the risk of complications, surgical treatment is usually only decided upon if the symptoms are severe enough to warrant surgery. This can be the case, for example, if the symptoms are present even at rest or if there are non-healing wounds. Before surgery is performed, the affected blood vessel must first be assessed by means of a vascular examination with contrast (angiography).
Various surgical options are available, such as cleaning the vessel (endarterectomy) at the site of the narrowing or surgically widening the narrowed area. In most cases, a bypass will be created for blocked leg arteries. This involves the use of a vascular prosthesis or a vein from your own vein. The choice of surgery naturally depends on many factors. The severity of the surgery depends on the location of the blockage in the body. Your surgeon can provide you with detailed information about this.POSSIBLE COMPLICATIONSNo procedure is without the risk of complications.
Fortunately, the Angioplasty method rarely has serious complications, although bleeding can occur at the injection site. It is, of course, possible that dilation of the vessel will not be successful, or that the stenosis may recur after a relatively short time.
Vascular surgery carries the usual risks of complications, such as wound infection, bleeding, thrombosis and pulmonary embolism, pneumonia, bladder infection, or heart attack.
Arterial surgery carries specific complications: secondary bleeding or occlusion of the vascular prosthesis or the used vein (thrombosis). If such a complication occurs, further surgery is often necessary. Naturally, every effort is made to minimize the risks. Therefore, you will often be thoroughly examined by an internist, cardiologist, or pulmonologist before the surgery, and numerous precautions will be taken.
After the surgery, you will need to continue taking medication to thin your blood. After discharge from the hospital, you will realize how difficult the surgery was. It can take a long time before you are fully recovered. If you have diabetes, high blood pressure, or high cholesterol, all of these should be well-controlled.
A healthy lifestyle is crucial, so: absolutely no smoking, plenty of exercise, not being overweight, and well-regulated blood pressure, blood sugar, and cholesterol levels. |
