Atherosclerosis of the vessels of the lower extremities treatment drugs

is a chronic disease characterized primarily by damage to medium and large arteries. On the inner walls of the arteries, fat deposits form in the form of atherosclerotic plaques, which can grow and block the lumen of the arteries - first partially, and in advanced cases, completely. As a result, the blood supply to the organs to which the artery leads is disrupted. The consequences of atherosclerosis are very serious and can be life-threatening. Atherosclerosis is the cause of coronary heart disease, heart attacks and strokes, and gangrene.

What it is

Atherosclerosis is one of the most common chronic arterial diseases. Because of it, an atherosclerotic plaque of cholesterol (cholesterol) forms in the wall of the vessel. These plaques narrow the lumen of the vessel, which affects blood flow, and in extremely advanced cases, plaques can completely block the blood flow. If this happens in a large artery, then the situation is fraught with serious complications, including death: cardiovascular diseases have been one of the main causes of mortality for many years. In addition, the presence of a plaque in a vessel changes the flow of blood: turbulence appears, which contributes to the formation of blood clots (platelet sticking together). The appearance of blood clots poses a risk of their breaking off and clogging the vessel in a narrow place.

Features of drug treatment: recommended drugs and ointments

If you have atherosclerosis of the vessels of the lower extremities, you should contact an angiologist. The course of therapy depends on the stage at which the disease was detected.

Conservative treatment is indicated for atherosclerosis of the first and second stages. Patients are prescribed the following drugs:

1. Myotropic antispasmodics. Their main effect is to eliminate vasospasm. Patients are prescribed medications Papaverine and No-shpa.
2. ACE inhibitors. The purpose of these drugs is to normalize blood pressure and reduce the risk of complications from the cardiovascular system. This group includes Enalapril, Captopril, Ramipril.
3. Statins. These are drugs whose action is aimed at reducing the activity of enzymes responsible for the production of cholesterol. Statins also increase the elasticity of artery walls and reduce the ability of platelets to aggregate. These drugs include Simvastatin and Atorvastatin.
4. Medicines of the nicotinic acid group. Their properties include normalizing the lipid composition of the blood, stimulating the process of fat breakdown and metabolic processes in general, and reducing the load on the heart muscle. A representative of this group of drugs is Nicotinic acid in the form of an injection solution.
5. Disaggregants. Such drugs improve the rheological properties of blood. This group includes the drugs Clopidogrel, Aspirin, Tiklid.
6. Thrombolytics (fibrinolytics). Such medications act on a blood clot that has formed in the artery, dissolving it. This improves blood flow. Names of drugs – Streptokinase, Prourokinase, Retaplase.

When treating atherosclerosis, patients take vitamins in tablet form. Vitamins that are useful for this disease are:

• A;
• Group B (B1, B2, B3, B6, B12, B15);
• WITH;
• D;
• E.

Dietary supplements are also useful. These are not medications, but food supplements that contain useful substances and microelements. Patients with atherosclerosis need antioxidants (lecithin) and microelements (calcium, selenium, magnesium).

In addition to tablets, patients are recommended to use topical preparations (gels and ointments) with anti-inflammatory and analgesic effects. The most commonly used medications are Diclofenac (1%) and Nimid.

Causes and prevention of atherosclerosis

The cause of atherosclerosis is a disorder in fat metabolism - the accumulation of cholesterol (namely low-density lipoproteins) in excess quantities. Cholesterol is necessary for the body because... participates in many important processes such as the production of certain hormones, and is also part of the cell membrane. With a genetic predisposition to the accumulation of cholesterol, with an unbalanced diet, this substance becomes too much, the body cannot cope with its breakdown, and the excess begins to be deposited in the walls of blood vessels, leading to atherosclerosis.

Factors contributing to the development of atherosclerosis are considered to be: high blood pressure, diabetes mellitus, excess weight, stress, smoking, alcohol, age over 50 years. It is worth noting that the development of the disease often begins at a young age, and by the age of 50-60 the main symptoms appear.

A good method of preventing atherosclerosis is an active lifestyle, balanced physical activity and the fight against excess weight, if present.

Most resources also offer a balanced diet, or more precisely, reducing the consumption of animal fats as the main method of preventing atherosclerosis, i.e. the appearance of excess cholesterol. But some studies indicate that vegetable fats and carbohydrates can provoke an increase in blood cholesterol levels. Therefore, in your approach to your own nutrition, you should be guided by common sense and moderation. Both animal and vegetable fats are necessary for the body to function comfortably, and their excess (like an excess of any other substances) can lead to lipid metabolism disorders. But all researchers agree that consuming vegetables and fruits, adding fish to the diet, and moderate calorie intake are key and proven methods for preventing problems with blood vessels and more.

Main risk factors

• smoking (the most dangerous factor),
• hyperlipoproteinemia (total cholesterol > 5 mmol/l, LDL > 3 mmol/l, Lp(a) > 50 mg/dl), - an increase in the amount of cholesterol and its fractions in the blood,
• arterial hypertension (high blood pressure) (systolic blood pressure > 140 mm Hg; diastolic blood pressure > 90 mm Hg),
• diabetes mellitus, obesity,
• sedentary lifestyle,
• emotional stress,
• drinking large amounts of alcohol,
• poor nutrition, hereditary predisposition, postmenopause, hyperfibrinogenemia (increased levels of fibrin (a protein involved in coagulation) in the blood),
• Homocysteinemia is a hereditary disease leading to an increase in homocysteine ​​protein in the blood.

Diagnostics

To diagnose atherosclerosis, both laboratory and instrumental methods can be used:

• general blood analysis;
• blood cholesterol level test;
• angiography (injection of a contrast agent into the blood, which reflects X-ray radiation and gives the specialist a detailed map of the condition of the vessels of the entire body);
• CT, MRI;
• coronary angiography (to study the coronary arteries);
• ECG, echocardiography (echocardiography);
• Holter ECG monitoring (to detect disturbances in heart rhythms);
• Ultrasound (to study the condition of the aorta, kidney vessels, heart).

Diagnostics usually does not cause problems for an experienced doctor - for this, our center has all the necessary equipment. After all, modern high-tech devices will be required - the better the equipment, the more detailed the examination data will be, which will help the doctor choose the optimal treatment method.

Bibliography

When compiling this article, we deliberately simplify some of the material so that it is understandable for non-specialists. If you are a doctor, we will be happy to answer your questions. Write or call us to discuss details. To prepare this material, the following publications were used:

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Atherosclerosis of the cerebral arteries

When cholesterol plaques form and the arteries of the brain narrow, the brain cells experience a lack of blood and nutrients. The following symptoms may indicate this condition:

• periodic dizziness,
• noise in ears,
• headache,
• increased fatigue,
• disturbances in coordination of movements.

The narrowing of the main carotid artery supplying the brain is identified as a separate diagnosis - carotid artery stenosis. Damage to the vessels supplying the brain carries the threat of a serious disease - ischemic stroke of the brain.

How does the disease appear?

In general, cholesterol (a type of fat) is important for the body, as it participates in the construction of vascular walls and is part of hormones and vitamins. In normal metabolism, cholesterol circulates between the liver and tissues; in excess, it is utilized in the liver. If the circulation is impaired, it accumulates in the form of plaques (together with fibrin and other substances) on the walls of blood vessels. The lumen of the vessel narrows, and the blood pressure on the walls automatically increases. Unfortunately, the process is almost inevitable and is observed in 85% of cases in patients over 50 years of age.

The following phenomena gradually develop:

• the walls of the vessel are subject to ulceration;
• scar tissue grows;
• deposits of lime salts are observed on the vascular walls.

The vessel at the site of plaque formation becomes calcified, and this leads to its destruction.

Atherosclerosis of the arteries of the lower extremities

Damage to the arteries of the lower extremities is called obliterating atherosclerosis. People over 65 years of age, especially men, are susceptible to it. This disease manifests itself in the following symptoms:

• pain in the calves, cramps at rest;
• pain when walking, causing you to limp;
• numbness in the legs, fatigue when walking;
• the appearance of non-healing wounds, and in advanced cases - ulcers.

If you do not consult a doctor in the presence of such symptoms, then there will be a threat of limb amputation as the only treatment measure for extremely advanced cases of obliterating atherosclerosis.

Approaches to surgical treatment for atherosclerotic lesions of the legs

If taking medications does not produce results, and also if the lesion is characterized as advanced, surgical treatment of atherosclerosis is required.

Main methods:

1. Balloon angioplasty. The essence of the operation is to insert a special catheter with a small balloon into the area of ​​narrowing and then inject pressure here by expanding the balloon. This helps restore patency. The operation is carried out under the control of a video camera and is low-traumatic. Patency of the artery after surgery is maintained for 5 years
2. Shunting. This method is used if there are contraindications to balloon angioplasty. A shunt, a kind of implant that restores blood flow by bypassing the affected area, is implanted into the femoral vein. This operation is classified as complex and requires two weeks of rehabilitation after it is performed. A patient who has undergone bypass surgery must regularly take medications (anticoagulants and statins), give up bad habits and control weight.
3. Endarterectomy. This is a radical operation that involves direct removal of an atherosclerotic plaque that has completely or partially blocked the lumen of the artery. It is performed under local or endotracheal anesthesia.

Patients who have undergone surgery to treat atherosclerotic disease must always control their weight so that the load on the lower extremities does not increase. To do this, you need to follow a healthy diet and avoid foods rich in “bad” fats. You also need to take medications to improve the rheological properties of the blood.

The sooner the pathology is identified and the sooner the course of treatment begins, the greater the chance of slowing its progression.

The most undesirable outcome of atherosclerosis is tissue death due to impaired blood flow and the development of gangrene. In this case, amputation is required, that is, surgical separation of the limb or part thereof. It all depends on the degree of damage and how timely the treatment process was started.

Atherosclerosis of the coronary arteries

Atherosclerosis of the coronary arteries (which bring blood to the tissues of the heart) is one of the main causes of coronary heart disease and myocardial infarction: when the disease affects the vessels of the heart, heart muscle cells begin to die due to insufficient nutrition. And the risk of blood clot formation and vessel blockage only aggravates the situation. This condition is extremely dangerous, life-threatening and requires consultation with a doctor. You should pay special attention to possible symptoms:

• chest pain;
• feeling of heaviness, tightness in the chest;
• arrhythmia, i.e. fast or slow heartbeat;
• feeling of a sinking heart.

Do not underestimate the above symptoms. Let us remember that the risk of developing atherosclerosis is present in many people. Complications of the disease without proper treatment are so dangerous that you should consult a doctor, even if you are afraid of a confirmed diagnosis or surgery. Modern medicine has advanced far in the treatment of atherosclerosis of various localizations.

Complications

Atherosclerosis of the lower extremities is dangerous due to the development of gangrene, muscle atrophy, and thromboembolism of blood vessels of vital organs in the event of plaque rupture.
Cardiac complications with damage to the coronary vessels include myocardial infarction, focal dystrophy of the heart muscle, myocardiosclerosis, and coronary sclerosis.

With obstruction of the mesenteric arteries, ischemic colitis and intestinal gangrene are possible, and secondary arterial hypertension is possible in the renal arteries. Cerebral consequences include hemorrhagic and ischemic stroke, transient ischemic attacks, and atherosclerotic dementia.

An aortic aneurysm poses a danger to the patient's life, the rupture of which in most cases is fatal.

Determination of the ankle-brachial index

The ankle-brachial index (ABI) is an important indicator in the diagnosis of atherosclerotic vascular lesions. This is the ratio of blood pressure in the lower leg to the pressure in the arm. At certain ABI values, a professional physician can detect atherosclerosis of peripheral vessels in the early stages and prevent its development.

At the Center for Pathology of the Circulatory Organs, determining ABI takes no more than 1 minute using the Boso ABI-System 100 system, as well as the Japanese VaSera VS-1000 Fukuda Denshi sphygmomanometer. The procedure is a simultaneous measurement of pressure on the limbs and does not require special preparation of the patient.

For a detailed study of blood vessels, our equipment also measures the speed of propagation of the pulse wave. High speed is a signal to start treatment. This is a characteristic indicator for the development of atherosclerosis.