Understanding Lower Extremity Artery Occlusion: Symptoms, Treatment, and Prevention

2024-02-17 02:00:00

life

Toes are particularly cold and dark… This might lead to a disease that requires amputation

Reporter Shin So-young

​If the color of your toes turns black and the temperature of your legs feels cold, you may suspect ‘lower extremity artery occlusion.’/Photo = Clip Art Korea If your toes start to turn black and the temperature of your legs feel cold from a certain day, you may suspect ‘lower extremity artery occlusion.’ You can try it. Lower extremity arterial occlusion is a representative type of peripheral arterial occlusion, in which peripheral blood vessels are narrowed or blocked due to various causes. If discovered early, improvement is possible with medication or simple procedures, but if appropriate treatment is not received in time, it may lead to leg amputation. Let’s learn more regarding this unfamiliar disease.

The prevalence of peripheral artery disease in adults in Korea is not high at around 4.6% (as of 2020), but caution is needed as the risk is increasing as dietary habits become westernized. This is because diabetes, high blood pressure, and heart disease can affect it. In particular, lower extremity artery occlusion presents the most severe symptoms. In the beginning, pain and cramps occur in the legs when moving, but the symptoms quickly subside when you rest, so it is often overlooked. However, following it progresses to a certain extent, the temperature of the legs becomes cold, the color of the toes turns black, and the wounds on the feet do not heal well. It is known to occur more commonly in men than in women. In addition, iliac artery occlusion, which is a blockage of the arteries near the pelvis, also shows similar symptoms.

Peripheral artery disease screening is simpler than you think. Diagnosis is made with an ankle-brachial index test to check arterial stiffness. Measure the blood pressure of both arms and both legs simultaneously while lying comfortably. If the ratio between the blood pressure measured at the ankle and the upper arm blood pressure measured at the arm is less than 0.9 (when ankle blood pressure is lower than 10%), lower extremity artery occlusion can be suspected.

Early detection of peripheral artery disease is important, so if you are in a high-risk group, you should not ignore even mild leg pain and visit a hospital. In particular, if you are a man in your 50s or older who has high blood pressure or heart disease and has smoked for a long time, it is recommended that you get tested in advance. If detected early, it can be improved with drug treatment (antiplatelet agents, vasodilators) and lifestyle changes such as cholesterol management.

However, if symptoms become severe, arterial occlusion has often progressed by more than 50%. Usually, people think that their legs are numb due to a lumbar disc, or they leave it alone because the pain goes away with a little rest. If necrosis is left untreated, half of the leg will have to be amputated within a year, so caution is required. If the blocked area is long but the surgical risk is low, bypass surgery is performed using the patient’s own vein or artificial blood vessel. However, patients with vascular disease often have chronic diseases, so there is a risk of complications from surgery. Therefore, following local anesthesia, balloon dilation (a procedure to insert a balloon into a blood vessel and inflate it to widen the blood vessel) or ▲ stent insertion (a procedure to insert a mesh stent into the blood vessel to prevent it from narrowing) is performed. Recently, atherectomy, which involves cutting and widening the inner walls of blood vessels, has been widely performed.

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