The leg arteries are responsible for supplying the legs with oxygen-rich blood. Various diseases can impair the function of these arteries, the most common being peripheral arterial occlusive disease (PAD) caused by atherosclerosis. The most common clinical pictures are
The treatment of leg artery disease aims to improve blood circulation, alleviate symptoms and prevent complications. The most important treatment approaches are
Lifestyle changes:
The first step to treatment is usually lifestyle changes. This includes stopping smoking, eating healthily, exercising regularly and losing weight.
Drug therapy:
Medication can be used to slow down the progression of the disease and alleviate symptoms. Blood thinners, cholesterol-lowering drugs, blood pressure medication and drugs to improve blood circulation are often used.
Interventional procedures:
For more severe constrictions or blockages, an angioplasty can be performed, in which the constricted artery is widened with a balloon. A stent is often inserted to keep the vessel open.
Surgical interventions:
In advanced cases, it may be necessary to peel (endarterectomy) or bridge a long-segment occlusion (bypass surgery), in which a bypass vessel is implanted to restore blood flow. In the case of aneurysms, surgical bridging or the insertion of a vascular replacement (end prosthesis, stent graft) may be necessary.
Peripheral arterial occlusive disease (PAD) due to atherosclerosis:
This disease is caused by the narrowing or occlusion of the leg arteries due to atherosclerosis (calcification of the arteries). This can lead to reduced blood flow in the legs. In milder forms, this is generally not noticeable under low levels of stress, but in more severe forms it can lead to a reduction in walking distance, and in severe cases PaVK can lead to tissue loss or amputations.
Aneurysms of the leg arteries:
An aneurysm is a localised dilation of the artery caused by an all-over weakness in the vessel wall. Unlike in other regions of the body, popliteal aneurysms are characterised by the risk of embolism and thus reduced blood flow to the leg, which can lead to amputation
Thromboses and embolisms in the leg arteries:
A sudden blockage of an artery by a blood clot (thrombus) can cause an acute reduction in the supply of blood to the affected leg. Thromboses are caused by existing constrictions in the leg arteries, embolisms are blood clots that usually originate from the heart and are caused by rhythm disturbances. This is an emergency and requires immediate medical attention.
Compression syndromes (popliteal entrapment syndrome)
Compression of the popliteal artery and, in rare cases, the vein is caused by congenitally unfavourable muscle and tendon cords. These lead to compression of the vessel under strain and initially to walking restrictions under heavier strain, e.g. running or playing football, and to occlusion or aneurysm formation of the popliteal artery after many years of exposure. Entrapment syndrome is a rare cause of PaVK that affects younger patients in particular, where a circulatory disorder due to atherosclerosis is absolutely unlikely and implausible.
Cystic adventitial degeneration
This is a very rare disease of the popliteal artery that can lead to a circulatory disorder. It is a cystic change in the outermost vascular layer that slowly narrows the vessel and can thus cause intermittent claudication.
The symptoms of leg artery disease depend on the severity and stage of the disease. Common signs are
Pain when walking (intermittent claudication, intermittent claudication):
Typically, pain occurs in the calves or thighs when walking, which disappears again after a short period of rest. This condition, known as “intermittent claudication”, is a classic symptom of PAD.
Cold and numbness: The affected legs may feel colder than the rest of the body and numbness may occur.
Changes to the skin and nails:
Poor circulation can lead to pale or bluish skin, slow healing of wounds and brittle nails.
Severe, unquenchable pain:
In advanced stages of PAD, pain also occurs at rest, especially at night, and open wounds (ulcers) or tissue death may occur.
Prevention of leg artery disease focuses on minimising risk factors and promoting a healthy lifestyle:
Quit smoking:
Quitting smoking is the most important step in reducing the risk of arterial disease.
Healthy diet:
A diet rich in fruit, vegetables, wholemeal products and healthy fats can help to lower cholesterol levels and keep blood vessels healthy.
Regular exercise:
Daily physical activity, such as walking or cycling, improves circulation and helps control weight.
Monitor blood pressure and cholesterol:
Regular checks and treatment of high blood pressure and high cholesterol are crucial to prevent arteriosclerosis.
Diabetes management:
Good control of blood glucose levels is important to prevent damage to the blood vessels.
Regular check-ups:
Regular visits to the doctor and check-ups are particularly important for people with known risk factors so that measures can be taken at an early stage.
Conventional and endovascular treatment of constrictive and dilatative pathologies of the leg arteries
Bypass surgery including pedal bypass surgery
Endoscopic bypass vein harvesting
Reconstruction of inguinal vascular occlusions and constrictions
Reconstruction of the profunda femoris artery
Surgical and endovascular treatment of popliteal aneurysms
Vein and plastic bypass system for vascular occlusion and dilatation
