Diseases of the arteries can affect three major areas in the body :
- The heart and coronary arteries
- The brain and aortic trunks Supra (carotid, subclavian and vertebral sub)
- Mainly the lower limbs, and sometimes the upper limbs
The discovery of a breach of any of these territories will have to perform a systematic review on the other two territories. The heart and coronary arteries are treated by the cardiac surgeon or interventional cardiologist, other territories are recognized as an expense by the vascular surgeon.
Two types of lesions
Mainly describes two types of lesions :
The related arteritis stenosis
Stenosis (narrowing of an artery located) or thrombosis (the artery is blocked on a more or less important segment, circulation can sometimes be lower throughput locum routes) :
- At Member, results in terms of its importance :
- Claudication: pain that occurs during exercise (eg cramp behind the calf walking) always after the same distance and disappears at rest
- Ongoing pain that occurs effortlessly for example at night behind the calves and subsided by the hanging leg position or walking. This is a later stage which requires rapid support
- Acute ischemia: brutal pain of the legs or arms with difficulty moving or motor paralysis, possibly with difficulty to feel or sensory paralysis, cooling and sometimes bluish or cyanosis. Immediate consultation urgently needed whatever the time or day as a member of survival is engaged.
- At the level of the carotid, carotid stenosis :
- can be asymptomatic :
- Cervical breath discovered by your doctor
- Discovered during a systematic review (Doppler ultrasound for example)
- discovered during a stroke: :
- Is temporary (TIA - Transient Cerebral Vascular Accident), final or (AVC - Consisting of Stroke)
- It may be :
- A difficulty in vision (hemianopia)
- A difficulty speaking (aphasia)
- Partial paralysis of the face (facial paralysis)
- A difficulty or inability to move a body part (motor paralysis)
- A difficulty to move or feel a part of the body (sensory paralysis)
supplementary examination
The affected arteries
Both lesions can affect all the arteries of the body but preferably in order of frequency :
The aorta and the iliac arteries :
- Usually asymptomatic and discovered systematic review
- Sometimes revealed by an unusual pain in the abdominal region or pain followed by loss of consciousness
- Evolution is towards rupture is most often fatal
The popliteal arteries :
- Affect arteries behind the knee
- Usually asymptomatic and discovered systematic review
- Sometimes revealed by a "ball beating behind the knee" or pain behind the calf walking
- Evolution is towards the increase in volume and they send blood clots that will clog the arteries of the legs can lead to the loss of the leg
Femoral arteries :
- Affect arteries in the thigh
- Usually asymptomatic and discovered systematic review
- Sometimes revealed by a "ball beating groin" or an increase in leg volume venous compression or pain behind the calf walking
- - Evolution is towards the increase in volume and they send blood clots that will clog the arteries of the legs
Other arterial territories.
Surgical treatment
Percutaneous Techniques
- They are done under local anesthesia
- They require a short hospital stay
- They do not require opening of the skin and are carried out by browsing the arteries from the inside after puncture by a needle in the groin (femoral) wrist (radial) or the elbow
- They can treat a localized narrowing (stenosis), or a blocked artery (thrombosis) with a balloon dilatation (angioplasty) associated or not with a metal prosthesis (stent), aspiration of a recent clot (thromboembolism suction) by local injection of the product dissolving recent clots (fibrinolysis)
- They concern most frequently :
- The coronary arteries
- The iliac arteries information sheet
- Femoral and popliteal arteries information sheet
- Leg arteries
- The carotid arteries in specific cases
- The aorta
- The subclavian artery
- etc
- They allow to treat some aneurysms :
- By setting up covered stents
- By embilisation (by blocking the aneurysm with small metal springs) ..
Micro-invasive techniques
- They are done under local anesthesia or under local or general anesthesia
- They require a short hospital stay of several days
- They comprise treating a patient by dilation - stent or stent covered with a small surgical opening
- For example aortic aneurysm/li>
- The postoperative fool often lighter than the conventional surgical treatment
Invasive surgical techniques
- They are locoregional anesthesia or general
- They require hospitalization a few days to several days (3 to 8 days in general)
- They needed to isolate the artery or arteries to be treated by using an opening in the skin
- Endarterectomy :
- Is to open an artery and remove the material which causes shrinkage or occlusion
- It can be done without the addition of foreign material or using some synthetic material
- It concerns mainly :
- The carotid
information sheet - The femoral tripod
information sheet - The aorta or iliac arteries
- The carotid
- Bridging :
- Is to create a new way to bypass a blocked artery starting from a permeable artery located above the lesion and arriving on a permeable artery located below the lesion
- The material used can be :
- Either the patient's (mainly the great saphenous vein on the thigh and leg)
- Either synthetic materials (Dacron, PTFE, polyurethane)
- It mainly concerns :
- The aorta and the iliac arteries
information sheet - The arteries of the thigh and leg
information sheet
- The aorta and the iliac arteries
- The flattening transplant :
- It is to open and process a particular carrier diseased artery aneurysm and restore using a bypass
- It concerns mainly :
- The aorta and the iliac arteries
information sheet - lFemoral or popliteal arteries
- The aorta and the iliac arteries