Obliterating endarteritis. Causes of occlusive disease.

Occlusive disease — a progressive peripheral arterial disease, accompanied by their stenosis and obliteration with the development of severe limb ischemia. The clinical course of obliterating endarteritis is characterized by intermittent claudication, pain in extremity, trophic disorders (cracked, dry skin and nails, ulcers); necrosis and gangrene of limbs.

Causes of obliterating endarteritis

In vascular surgery and cardiology question about the reasons of obliterating endarteritis remains controversial. Examines the role of infectious-toxic, allergic, hormonal, nervous, autoimmune factors that influence the pathology of blood coagulation. Probably multifactorial etiology of obliterating endarteritis.

It is known that for long-term spasms of peripheral vascular disease predisposes smoking, chronic intoxication, cooling and frostbite limb innervation of peripheral neuritis due to chronic sciatic nerve injury limb. According to some sources, the development of obliterating endarteritis promotes disease typhus, syphilis, athlete’s foot.

Considerable importance in the etiology of obliterating endarteritis assigned neuro-psychological factors, hormonal function of the adrenal glands and gonads, provoking vasospastic reactions. In favor of an autoimmune mechanism obliterating endarteritis evidenced by the appearance of antibodies to the endothelium of blood vessels, reducing the number of lymphocytes.

How to treat obliterating endarteritis disease?

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Obliterating endarteritis

Obliterating endarteritis

Symptoms of obliterating endarteritis

For obliterating endarteritis passes 4 stages: ischemic trophic disorders, ulcerative necrotic, gangrenous.

Ischemic syndrome is characterized by the appearance of fatigue, chilliness legs, paresthesia, numbness of fingers, cramps in the calves and feet.

Sometimes occlusive disease begins with phenomena migratory thrombophlebitis (thromboangiitis obliterans, Buerger’s disease), proceeds with the formation of blood clots in the veins of the subcutaneous leg and foot.

In the second stage of obliterating endarteritis all these phenomena are amplified, there are pains in the limbs during walking — intermittent claudication, which causes the patient to take frequent rest stops. Pain in the muscles of the lower leg are concentrated in the area of the soles or toes. Skin becomes «marble» or cyanotic, dry; growth retardation and nail deformity; marked loss of hair on the legs. Pulsation of the arteries to stop hardly detectable or absent on one leg.

Necrotizing stage obliterating endarteritis correspond pain at rest (especially at night), atrophy of the muscles of the legs, swelling of the skin, trophic ulcers on the feet and toes. Ulcerative process often join lymphangitis, thrombophlebitis. Pulsation of the arteries in the feet is not defined.

In the last stage of obliterating endarteritis develops dry or wet gangrene of the lower extremities. Gangrene is usually associated with the influence of external factors (injuries, cuts the skin) or with an existing ulcer. Often affects the foot and toes, rarely gangrene spreads on fabric shin. Evolving with gangrene syndrome causes toxemia resort to amputation.

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