If it's too light, it's "leg-threatening", and if it's too heavy, it's "life-threatening"! What exactly is the "leg-threatening"?

Author: Liu Huajiang, deputy chief physician, First Affiliated Hospital of Hainan Medical University

Du Xinyue Hainan Medical University

Reviewer: Fu Chuangang, Chief Physician, Qionghai Traditional Chinese Medicine Hospital

Mr. Liu, 52, suffered from pain in his left lower limb accompanied by coldness and numbness, and difficulty walking. His family pushed him into the interventional vascular surgery clinic in a wheelchair. After asking about his condition and examining his body, the doctor said, "This is a leg infarction." The patient and his family members were confused. They had heard of "cerebral infarction (cerebral infarction)" and "myocardial infarction (myocardial infarction)", but had never heard of "leg infarction". What was this?

1. What is "leg stalk"?

Lower extremity arteriosclerosis obliterans, commonly known as "leg infarction", is a chronic progressive disease. Its principle is similar to that of cerebral infarction and myocardial infarction, both of which are caused by insufficient blood supply due to blood vessel blockage. Lower extremity arteriosclerosis obliterans is mainly caused by arteriosclerosis, which manifests as thickening of the intima, stenosis or occlusion of the lumen of the lower extremity blood supply arteries. This lesion can lead to insufficient blood supply to the limbs, causing a series of clinical symptoms such as intermittent claudication and limb ulcers and gangrene. If not treated in time, it may increase the risk of amputation and even endanger life.

2. What are the main risk factors and preventive measures for lower limb arteriosclerosis obliterans?

Generally, men over 50 are more likely to get this disease, and its onset is related to factors such as smoking, diabetes, high blood lipids and high blood pressure. The preventive measures are as follows:

1. Quit smoking and don’t let your blood vessels age quickly.

2. Control blood sugar, especially for diabetic patients.

3. Blood lipids should not be high and the blood should not be too "thick".

4. Eat healthily, with less oil and cholesterol.

5. Control your blood pressure and avoid injuring your blood vessels.

6. Have regular physical examinations to detect and treat diseases early and reduce the risk of disease.

3. What is the pathogenesis of lower limb arteriosclerosis obliterans?

Lower limb arteriosclerosis obliterans, in layman's terms, means there are problems with the cells in the blood vessels and the fat in the blood.

1. Damage to the blood vessel wall If the cells on the blood vessel wall are damaged, they will attract vascular smooth muscle cells to repair it.

2. When fat accumulates and the blood vessel wall is damaged, the "bad cholesterol" (low-density lipoprotein) in the blood will take the opportunity to enter the blood vessel wall and slowly accumulate.

3. Changes in blood flow Blood flow changes direction at the bifurcation of blood vessels. This change causes continuous friction on the blood vessel walls, just like water washing away the river bank.

The above factors cause hard lumps to form on the blood vessel walls, which will block blood flow and cause discomfort in the legs.

4. What are the symptoms of lower limb arteriosclerosis obliterans?

Lower extremity arteriosclerosis obliterans is a disease in which blood vessels gradually narrow. The symptoms are divided into four stages:

1. During mild symptoms, the calves and feet feel cold because the blood vessels begin to narrow, resulting in reduced blood flow.

2. During intermittent claudication, your legs will hurt when you walk and you will need to stop and rest. The more serious the disease is, the shorter the distance you can walk.

3. During the resting pain period, your legs hurt even when you are not walking, and it hurts more at night, which means that your vascular problems are serious.

4. During the ulcer or gangrene stage, sores may appear on the legs and even the flesh may begin to rot.

Simply put, this disease causes blood vessels to become narrower and narrower, and symptoms to become more and more severe, eventually requiring amputation or even death.

5. Simple self-examination method

Lower extremity arteriosclerosis obliterans can be detected through a simple three-step self-examination method of "look, touch, and walk":

1. Observe the color of your feet and ankles. If they turn white or dark purple, it may indicate poor blood circulation.

2. Feel the temperature of your feet with your hands. If your feet are cold, blood flow may be blocked. Check the dorsalis pedis artery between the first and second toes on the dorsum of the foot. If the pulse is weak or untraceable, the blood vessels may be blocked. Compare the temperature of the two feet and the pulse of the dorsalis pedis artery. If they are different, pay attention!

3. Walk at a normal speed for a while and pay attention to whether you have pain, soreness, or other discomfort in your calves or feet. If your legs hurt when you walk and you need to rest before you can continue walking, it may be intermittent claudication.

By observing, touching and walking the limbs, you can preliminarily determine whether you have lower limb arteriosclerosis obliterans. If you find any abnormalities, you should seek medical attention as soon as possible to prevent the disease. Remember, pay attention to vascular health and start from daily life.

6. If you suspect you have lower limb arteriosclerosis obliterans, how should you seek medical treatment?

1. Find the right doctor. If you suffer from lower limb arteriosclerosis obliterans, you should find a doctor who specializes in vascular problems, such as an interventional therapy doctor or a vascular surgeon.

2. Comprehensive examination requires a comprehensive physical examination, including testing of blood pressure, blood sugar and blood lipids.

3. Specialized examinations If there are problems with the initial examination, the doctor will do more detailed examinations, such as color Doppler ultrasound (color ultrasound) or CT angiography (CTA) to confirm the condition. Sometimes, digital subtraction angiography may also be required.

7. How to treat lower limb arteriosclerosis obliterans?

There are two main treatments for lower extremity arteriosclerosis obliterans:

1. Basic treatment

Quit smoking: Smoking can harden blood vessels, so quitting smoking helps keep blood vessels healthy.

Figure 1 Copyright image, no permission to reprint

Control chronic diseases: Chronic diseases such as hypertension, hyperlipidemia and diabetes should be controlled to avoid accelerating vascular diseases.

2. Interventional treatment

Minimally invasive surgery: No large incision is required, reducing patients’ fear and postoperative recovery time.

There are many methods: thrombus aspiration, plaque removal, drug-coated balloon and stent implantation to clear the blockage through intravascular treatment.

Interventional therapy can quickly improve blood flow and is especially effective for large blood vessel blockage. It also has accurate positioning, minimal trauma and rapid recovery.

8. How to recover after treatment of lower limb arteriosclerosis obliterans?

Key points for recovery after treatment of lower limb arteriosclerosis obliterans:

1. Maintain a good attitude and be in a good mood, be less nervous and reduce stress.

2. Combine work and rest. Don’t work too hard and maintain a balance between work and rest.

3. Eat a healthy diet, eat less salt, oil, and sugar, quit smoking and drinking, and avoid spicy food.

4. Exercise moderately for at least half an hour every day to strengthen your body.

5. Have regular physical examinations and monitor blood pressure, blood lipids and blood sugar.

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