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Diabetic Foot Wounds And Peripheral Vascular Disease

A section dedicated to those living with diabetes mellitus and the elderly with blood starving limbs (literally put arms or legs) , a situation medics call peripheral vascular disease

We start with a pictorial of blood starving  legs , majority of which are painfully lost (amputated) , we can save some legs for sure !

Peripheral vascular disease (also called peripheral arterial disease) is a common condition in which narrowed arteries reduce blood flow to the arms or legs.

Peripheral artery disease is usually a sign of a buildup of fatty deposits in the arteries (atherosclerosis). Atherosclerosis causes narrowing of the arteries that can reduce blood flow in the legs and, sometimes, the arms.

Severe blood vessel narrowing due to a plaque ( yellow)

In peripheral artery disease (PAD), the legs or arms — usually the legs — don’t receive enough blood flow to keep up with demand. This may cause leg pain when walking (claudication) and other symptoms.

What Are The Risk Factors For Peripheral Vascular Disease?

A risk factor increases your chance of developing a disease. Some can be changed, others cannot.

Risk factors that you can’t change

  • Age (especially older than age 50)
  •  History of heart disease
  • Male gender
  • Postmenopausal women
  • Family history of high cholesterol, high blood pressure, or peripheral vascular disease 

Risk factors that may be changed or treated

  • Coronary artery disease (Heart Vessel Disease)
  • Diabetes
  • High cholesterol
  • High blood pressure
  • Overweight
  • Physical inactivity
  • Smoking or use of tobacco products

Those who smoke or have diabetes have the highest risk of complications from peripheral vascular disease because these risk factors also cause impaired blood flow.

Symptoms Of Peripheral Vascular Disease

  •  Coldness in the lower leg or foot, especially when compared with the other side
  • Leg numbness.
  • Painful cramping in the affected limb (leg or arm) during physical activity such as walking or climbing stairs.
  • Reddish-blue or black discoloration of the leg / foot.
  • Skin color changes on the leg
  •  Wounds on the toes, feet or legs that won’t heal
  •  Erectile dysfunction
  •  Hair loss on legs
  • If peripheral artery disease gets worse, pain may occur during rest or when lying down. The pain may interrupt sleep and quality of life.

Treatment Of Peripheral Vascular Disease

A multi-disciplinary approach is needed , to save the limbs ( arm or leg ) and avoid major amputations.

  1. Life Style Modification ; Includes exercising, eating a healthy diet etc.
    Here , good blood glucose control (for diabetics) is key.
  2. Balloon angioplasty and / or stenting 
     A Way To Treat Peripheral Vascular Disease Without Surgery

     

This procedure is done while you are awake.

A small tube called balloon catheter is directed towards the narrowed blood vessel and is inflated to press the plaque against the artery wall so that the vessel opens up.

At times a stent may be deployed to keep vessel open.

I now offer this cutting edge treatment is selected patients with blood starving limbs (peripheral vascular disease)

  1.  Surgery : In some patients with peripheral vascular disease , vascular surgery is a sound option . Surgery can include ;

Bypass : Simply put , the blocked vessel segment is bypassed , to ensure continuous blood flow to the leg or arm. Think of a surgical bypass as a road detour.

Do you see how the occluded artery ( arrow) has been skipped ( bypass) by a new vessel (bold arrow) ?

There is actually a lot , a lot that can be done by a dedicated limb saving team.

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