Occlusive Disease

The vascular system is made up of arteries that carry oxygen-rich blood from the heart to all body parts, and veins that return oxygen-needy blood back to the lungs to be saturated with oxygen once again. After many years of habits such as smoking, high-fat diets, and inactivity, in conjunction with disease processes, such as hypertension and diabetes, the vein walls become rigid, the inner diameters narrow, and blockages may occur. Blood flow to the legs is particularly affected by this process and may not provide adequate blood flow to muscle tissue. Many patients experience leg pain, referred to as intermittent claudication, which occurs as a result of this lack of oxygen. This pain may increase with exercise, as activity increases the need for oxygenation and may be alleviated by rest. In some patients this lack of blood flow can occur slowly, and the vascular system may build alternative routes called collateral vessels around the affected vessels. Discoloration, numbness, and cool skin temperatures are other common symptoms, again occurring more frequently in the lower legs and feet.

The treatments for lower extremity occlude disease are primarily risk factor modification and certain medical therapies. Operation is reserved for those who have the most severe symptoms and complications. For example, smoking cessation is critical and foremost. A walking program, where the patient walks for 30 minutes 4 to 5 times a week, stopping as needed, is recommended, as well. Consideration of a baby aspirin, a cholesterol-lowering statin agent, and an ACE inhibitor for blood pressure control is also recommended, if appropriate. If low blood flow is severe enough to prevent a wound or sore from healing, or if pain occurs at rest, this is an indication for an endovascular or surgical bypass.