Treatment of peripheral artery diseases at the Sachsenhausen Clinic, Germany, Frankfurt

Peripheral Artery Disease

If the arteries have irregularities in the walls, constrictions and other anomalies, we can assume the presence of occlusive artery diseases. In most cases, these diseases affect the arteries of the pelvis and legs and are defined by doctors as peripheral artery diseases.

Clots or narrow areas in the blood vessels make blood flow difficult and the affected parts of the body no longer receive sufficient oxygenated blood. In the initial stage, blood circulation is still sufficient, so that no complaints appear during rest or physical activity, but then pains occur during walking.

There is a rather inclusive term for this disease – “the disease of shop windows” – in folk speech, as those suffering from peripheral artery disease constantly have to make short breaks in walking due to pain. Even at this initial stage of the disease, patients’ quality of life and life expectancy are significantly reduced.

Do You Have Circulatory Problems?

If you suffer from peripheral artery disease, you need to see a doctor who specializes in angiology (vascular medicine).

Highly qualified doctors of our vascular surgery department are always ready to assist you in the treatment of peripheral artery diseases by using the most advanced conservative and surgical methods of treatment.

Doctors at our clinic are known for:

  • A responsible attitude to treatment
  • Precise early detection of diseases
  • Optimal therapy and care

Why is Peripheral Artery Disease So Dangerous?

  • Peripheral artery disease initially progresses without symptoms
  • Peripheral artery disease may be a precursor to heart attack and stroke
  • Peripheral artery disease may cause sudden vascular blockages, which increases the risk of limb amputation
  • Peripheral artery disease reduces life expectancy by about 10 years
  • Mortality in patients with peripheral artery disease is twice as high

Atherosclerosis as a cause of peripheral artery disease is a serious disease that has long been underestimated. In most cases, not only the arteries in the legs, but also the arteries in the whole body are narrowed. Consequently, patients with peripheral artery disease are at increased risk of heart attack and stroke – more than 75% of all patients with peripheral artery disease are at risk of early death.

Peripheral Artery Disease

Less than half of people over 65 years of age who sometimes have problems with their legs consult a doctor, as only 1 in 10 patients with peripheral artery disease had obvious symptoms of the disease. Therefore, it is important to detect peripheral artery disease in proper time – take your symptoms seriously and listen to the signals of your body!

Signs of Peripheral Artery Disease

  • Cool, pale and marble skin
  • Dry skin of the legs and feet
  • Pain during walking: in the calves, hips or buttocks
  • Sever keratinization of the soles of the feet
  • Unusually slowly growing nails
  • Hair loss on the legs
  • Erectile dysfunction
  • Small wounds heal significantly slower

Risk of heart attack

More than half of all people who suffer from peripheral artery diseases have deposits on the arteries of the heart. This results in the fact that during exercise insufficiently oxygenated blood is pumped to the heart, which leads to symptoms of angina (heart pain, tightness in the chest), heart arrhythmia or shortness of breath. As a chronic consequence, heart failure can develop.

If a blood clot causes a sudden blockage of the coronary artery, a heart attack occurs. The heart tissue dies and there is a critical danger to life.

Risk of Stroke

Patients with peripheral artery disease also often have narrowing in the arteries that supply the brain.

The warning signs of circulatory disorders in the brain are:

  • Vision impairment (defects of the field of vision)
  • Sudden short-term blindness
  • “Double pictures”
  • Tingling, numbness of the head surface
  • Weakness in hands or feet
  • Facial paralysis (drooping corner of the mouth)
  • Speech impairment

If the cerebral artery is blocked with a clot of blood, it comes down to a stroke. You need to take immediate action. In the event of an oxygen deficiency, the nerve cells die even faster than the heart muscle tissue.

Treatment of Peripheral Artery Diseases

Our vascular doctors will choose the most spare and effective treatment strategy based on your complaints and the latest diagnostic equipment. Each treatment is associated with potential risks. To reduce them, our doctors will select it individually for each patient. This can be conservative treatment to improve circulation, catheter therapy with balloon dilatation or surgery.

Peripheral artery diseases must be treated and preferably at an early stage. If you ignore the disease and lose time, you run the risk of facing more serious problems – a heart attack, a stroke or amputation of the limbs.

Physical Activity Improves Your Circulation

Those who want to protect themselves from further deterioration of blood circulation and maintain the ability to walk for long periods of time should keep active.

If the blood flow is only slightly constrained, walking helps well, and not necessarily over long distances. As a result of movement, small blood vessels can expand around the narrowing of the artery, so the blood is diverted and it supplies the poorly maintained leg areas again.

Interval walking

  • Gymnastics, such as foot exercises, squats
  • Aqua running
  • Nordic walking
  • Medicinal Treatment

It is prescribed for thinning the blood and anesthesia. Acetylsalicylic acid prevents platelet adhesion, a new substance is clopidogrel.

There are also a number of vasoactive agents used to treat patients who are in stage II (e.g. naphthidrofuryl, cilostasol). Studies have shown that these substances prevent further vasoconstriction and slow down the growth of deposits. The patients who received treatment could walk longer distances and experienced less pain than those who did not take the substance.

In advanced stages III and IV, patients who cannot undergo surgery receive prostonoid infusion therapy such as prostaglandin E1 or hyloprostate. In addition to its beneficial effect on the walls of vessels and arteries, this substance significantly reduces pain at rest.

Catheter Therapy

A catheter is a long tube that is inserted into a vessel and placed in the area of its constriction or blockage. Our specialists most often use the technique of percutaneous angioplasty which gives the best result in the treatment of peripheral artery diseases.

The procedure begins with a puncture of the leg artery in the groin area (under local anesthesia) and the placement of a balloon catheter in the area of the vessel constriction. Then, the balloon is blown up with pressure up to 12 atmospheres, thus leveling out the walls of the vessel and eliminating the narrowing of the vessel, so that the blood can flow freely again. In case of a severe narrowing of the vessel, it is often necessary to install a mesh stent, which will prevent the formation of calcium deposits on its walls and, as a result, a second narrowing.

Catheter therapy is a sparing way to treat peripheral artery diseases with low risk, which makes it preferable for the vast majority of patients.

Advantages of catheter therapy:

  • Less risky than surgery
  • It doesn’t need anesthesia
  • Short hospital stays
  • Can be performed several times

Surgery

Surgical treatment of peripheral arterial diseases is necessary if long-distance walking is painful or impossible, the legs hurt at rest, small wounds of the limbs have a limited healing capacity and catheter therapy is not possible.

During the operation, the constricted or blocked artery is opened surgically and a “bypass” is made around the constriction. The material used for the bypass is the patient’s own vein or plastic tube. In advanced stages of the disease, this method does not guarantee a complete recovery – even after a successful operation, the vessel or bypass may close again.

Beware of Injuries!

Even minor injuries, especially on the legs, pose great danger to patients with peripheral artery disease. Diabetics are even more vulnerable to risk. Because of poor circulation, the damaged areas heal so badly that the surrounding tissue often dies. Pay close attention to your feet and gently cut your toenails. Problem areas are between the toes, on the heels.

In the event of injury or exacerbation of symptoms, seek medical advice immediately!

Prof., Dr. med. Plamen Staikov

Prof., Dr. med. Plamen Staikov

Medical Director, Head physician

Holger Bahn

Holger Bahn

Senior physician

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