Synonym(s)
DefinitionThis section has been translated automatically.
Most frequent form of chronic arterial occlusive disease.
EtiopathogenesisThis section has been translated automatically.
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ManifestationThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
- Typical are:
- Changes in pulse quality (attenuated or missing)
- Changes in skin temperature (reduced)
- changes in skin colour (pale, sometimes reddish)
- Skin trophic disorders with circumscribed alopecia
- Sensitivity disorders
- Pain of varying degrees of severity.
- Progression in 4 stages (according to Fontaine):
- Stage I: Freedom from symptoms or atypical sensations in the foot, leg.
- Stage II: Latent pain only occurring after certain strains (intermittent claudication).
- Stage III: Pain at rest and possibly beginning trophic disorders (necrosis).
- Stage IV: Gangrene.
DiagnosisThis section has been translated automatically.
- Clinical picture, medical history, standard examination program.
- Palpation and auscultation of the arteries.
- Functional tests, mechanical and electronic oscillography, rheography, ultrasound Doppler method, in some cases angiography.
General therapyThis section has been translated automatically.
Prophylactic and secondary preventive measures (ban on nicotine, treatment of risk factors: hypertension, diabetes, obesity, fats, cholesterol). Avoidance of exposure to cold and wet, tight footwear and other compression, avoidance of chemical, electrical and thermal stimuli. Avoidance of injuries, toe nail manipulation, etc. Special conservative measures: Occupational therapy: Active muscle training; walking training, groin pulse must be palpable (not for stage III to IV).
Internal therapyThis section has been translated automatically.
- Vasoactive substances (e.g. Trental, Dusodril, Prostavasin). Vasodilatants, isovolaemic haemodilution (bloodletting and volume replacement with e.g. HAES), viscosity changing drugs (e.g. HAES), aggregation inhibitors (e.g. ASS).
- Interventional radiology: Percutaneous transluminal angioplasty followed by marcumarization for short-stretch occlusions.
Operative therapieThis section has been translated automatically.
- Transluminal percutaneous catheter dilatation ( yolk technique), best indication in stage II.
- Alternatively open TEA (thrombendarteriectomy) or anatomical/extraanatomical bypass surgery.
TablesThis section has been translated automatically.
Arterial occlusive disease (AVK) - rare causes
Disease |
Etiology/findings |
Pseudoxanthoma elasticum |
Pseudoxanthomas of the skin, vascular retinal strips, femoralis occlusion (Darier-Groenblad-Strandberg syndrome) |
Neurofibromatosis |
renal artery stenoses, more rarely stenoses of the aorta, mesenteric and iliac arteries in children and adolescents |
drug abuse (amphetamine, LSD) |
Necrotizing angiitis (microaneurysms) |
Chronic arsenic poisoning |
Fibrous thickening of small and medium-sized arteries (high arsenic content in drinking water) |
Carbon disulfide exposure |
Premature atheromatosis |
Amyloidosis |
Arteriolar and arterial amyloidosis, muscle pain, intermittent claudication (received foot pulses) |
Werner syndrome |
prepubertal hair graying, dwarfism, hypogenitalism, cataract, scleroderma, osteoporosis, early arterial occlusion, familial clustering |
Retroperitoneal fibrosis |
Ureteral, arterial and venous compression in the small pelvis due to fibrosis |
Osteohypertrophy |
Artery compression due to larger exostoses |
Prolonged Shock |
Acral symmetrical gangrene due to extreme centralization, diffuse intravascular coagulation |
Endogenous oxalosis |
Diffuse visceral and peripheral arterial oxalate deposits in the final stage of uremia |
Homocystinemia |
Thrombocytopenia tendency |
Progressive arterial occlusive disease |
Fibrous tissue proliferation between endothelium and lamina elastica interna of small arteries and arterioles. Complications: skin florescences, intestinal perforation, cerebral insult (Degos-Delort-Tricot syndrome) |
Incoming links (8)
Arterial occlusive disease of chronic visceral arteries; Arterial occlusive disease peripheral; Arterial occlusive disease peripheral chronic; Autogenic training; Compression bandage phlebological; Ginkgonis folium; Partial baths; Restless legs syndrome;Disclaimer
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