Arteriosclerosis obliterans, diabetic foot and thromboangiitis obliterans of lower limbs are collectively referred to as ischemic vascular diseases of lower limbs. The main reason is insufficient blood supply caused by stenosis or occlusion of arterioles in lower limbs, leading to necrosis. The main manifestations are ischemic necrosis and amputation leading to gangrene of limbs, which brings great inconvenience to patients' lives.
The interventional therapy center of Henan Union Medical College Hospital introduced large-scale DSA equipment from Shimadzu, Japan, and successfully implanted arterial stents in the lower limbs to treat the disease. Dortor, the earliest American doctor in this technology, dilated blood vessels for a patient who didn't want to amputate, so that the patient saved his limbs and caused a sensation in the whole medical field. With the continuous development of technology in recent decades, the research and development of special interventional materials, perfusion thrombolysis, angioplasty, stent implantation, intravascular thrombus cutting and aspiration and a series of complete sets of intravascular minimally invasive interventional treatment techniques have gradually replaced the traditional treatment methods and become the first choice for the treatment of this disease, which fundamentally avoids the pain of amputation. At the same time, this technology has been popularized abroad, but in China, because the intervention started late, only a few hospitals can carry out this business, which leads to many patients unable to do it. What makes people feel extremely gratified is that after years of painstaking research and unremitting efforts, the experts in the interventional treatment center of Henan Union Medical College Hospital have made their painstaking interventional treatment leap to a new level, which has made many patients (arteriosclerosis obliterans of lower limbs, diabetic foot, thromboangiitis obliterans) no longer worry about amputation, and interventional treatment has made patients' lives move towards a healthy road!
Know vasculitis (vasculitis symptoms) What are the symptoms of vasculitis?
True vasculitis: thromboangiitis obliterans, short for thromboangiitis obliterans, is a chronic occlusive disease of small and medium arteries in limbs. Its pathological changes are segmental and non-suppurative inflammation of the wall of small and medium-sized arteries with thrombosis in the arterial lumen, and pain in the distal limbs due to occlusion and ischemia of the lumen. The main features of this disease are as follows: (1) This disease mostly occurs in young men; (2) Cold limbs, especially toes, chills, numbness and paresthesia are common early symptoms; (3) Pain is the main symptom of this disease, which is manifested as: ① Intermittent claudication: After the patient walks for a certain distance, the calf or foot muscles appear numbness, soreness, pain, convulsion, weakness and other symptoms. If he keeps walking, his symptoms will get worse and he will be forced to stop at last. After standing in the same place for a period of time, the pain will be relieved quickly, and he can continue to walk, but the above symptoms will reappear after walking. This symptom is called intermittent claudication, which is a typical manifestation of arterial insufficiency of lower limbs. ② Resting pain: When arterial ischemia is severe, the pain in the affected limb is severe and lasting, and it still lasts at rest, making it difficult to sleep all night. Even my toes are broken and infected, and the pain is worse.
"Vasculitis" of the elderly: arteriosclerosis obliterans of lower limbs, not vasculitis, is a manifestation of systemic arteriosclerosis and one of the common vascular diseases in middle-aged and elderly people. Its pathological features are thickening and hardening of intima of large and medium-sized arteries such as abdominal aorta, iliac artery, femoral artery and popliteal artery, forming atherosclerotic plaque and calcification, secondary thrombosis, leading to stenosis or occlusion of arterial lumen, which is similar to vasculitis, so it is often mistaken for vasculitis. Many middle-aged and elderly patients have lower limb pain, muscle aches and weakness, and cannot walk normally (that is, intermittent claudication). They often think that it is caused by hyperosteogeny, osteoporosis, lumbar disc herniation and rheumatism. Moreover, they took a lot of drugs for a long time and didn't go to the hospital to see a specialist in time, and even some patients were forced to amputate.
Diabetic foot: the main cause is arterial occlusion, not diabetes itself. Its pathological features are thickening and hardening of intima of abdominal aorta, iliac artery, femoral artery and popliteal artery, forming atherosclerotic plaque and calcification, secondary thrombosis, leading to stenosis or occlusion of arterial lumen.
Takayasu arteritis: Takayasu arteritis is a chronic progressive nonspecific inflammation of the aorta and its main branches, which often causes stenosis or occlusion in different parts. Takayasu arteritis occurs mostly in young women. The etiology of Takayasu's arteritis is not clear, and the possible factors considered include rheumatic disease (rheumatic fever or systemic lupus erythematosus), infection (tuberculosis or syphilis), congenital vascular abnormality and trauma. It may belong to the category of autoimmune diseases. Suspected disease: ① Ischemic symptoms on one or both upper limbs, accompanied by pulse weakening or disappearance, and lower or undetectable blood pressure on upper limbs. ② Symptoms of cerebral ischemia are accompanied by unilateral or bilateral carotid pulse weakening or disappearing, and neck vascular murmur. ③ Patients with hypertension or intractable hypertension accompanied by high-pitched systolic vascular murmur in the upper abdomen were above grade 2 on schedule. ④ Unexplained low fever is accompanied by vascular murmur, abnormal pulse changes in limbs or blood pressure difference between upper and lower limbs. ⑤ Pulse-free disease with fundus changes. If in doubt, further examination is needed. Aortography can determine the location, degree and scope of arterial stenosis.
What is the treatment of vasculitis? The treatment of vasculitis?
Lower extremity arteriosclerosis obliterans, diabetic foot, thromboangiitis obliterans (vasculitis). Early appropriate medical treatment 1 acute heparin or low molecular weight heparin, 2 chronic aspirin+clopidogrel, aspirin+ambroxol. Once intermittent claudication and resting pain occur, immediately consider intervention measures.
There are three treatment methods for arteriosclerosis obliterans of lower limbs, diabetic foot and thromboangiitis obliterans: intravascular minimally invasive interventional therapy has the characteristics of no operation, little pain, strong repeatability and quick recovery, surgical treatment (vascular reconstruction and amputation) and autologous stem cell transplantation.