Endarteritis

General characteristic of a disease

The endarteritis (the most widespread synonym "obliterating endarteritis") is the serious steadily progressing disease of arteries leading to full closing of their gleam, disturbance of blood circulation in the struck body and to a gangrenosis. Most often the endarteritis strikes vessels of legs. Endarteritis symptoms most often appear at the men of middle and young age abusing smoking. Treatment of an endarteritis is rather effective only at early stages of a disease, at deep defeat of fabrics and a gangrenosis amputation of extremities is shown.

Reasons of development of an endarteritis

The nature of an obliterating endarteritis is up to the end not established. Most of doctors consider that in development of an endarteritis of the lower extremities the autoimmune antibodies causing inflammatory damage to a wall of arteries as a result of which connecting fabric develops and a gleam of a vessel are guilty is narrowed. The inflammation and a sclerosis strike the fatty tissue surrounding vessels. Connecting fabric squeezes arteries outside that even more aggravates a situation.

Besides, connection of development of an obliterating endarteritis with chronic poisoning of an organism with nicotine and other poisons, psychological tension and regular overcooling of legs is established.

Endarteritis – symptoms of development of a disease

Patients with an endarteritis of the lower extremities pay attention to the following symptoms:

- periodically arising feeling of a cold snap of legs

- feeling of "crawling of goosebumps"

- increase in perspiration of the lower extremities

- pallor and xeroderma of legs

- fragility and posineniye of nails of toes

- bystry fatigue when walking

- spasms and pain when walking, and later and at rest

- reduction of a pulsation by arteries of the back of foot

- emergence of hypostasis of the lower extremities

- formation of ulcers standing

The alternating lameness - the most important symptom of an endarteritis

The patient with an obliterating endarteritis can be recognized on the street on specific gait. These patients go, stopping through several steps. This results from the fact that because of a lack of intake of oxygen to fabrics on the narrowed vessels in gastrocnemius muscles the spasm develops and there is severe pain.

After a stop the need of muscles for oxygen decreases a little, blood supply improves, the spasm vanishes and pain passes. But costs to the person sick with an endarteritis, to begin the movement as everything repeats at first.

Development of an endarteritis

The progressing cyclic current with alternation of the periods of an aggravation and remission is characteristic of an obliterating endarteritis. In its development allocate several phases.

• Phase of dystrophy of nerve terminations. Development of dystrophic processes in the nerve terminations suitable to vessels is characteristic of it. The gleam of a vessel is narrowed slightly, food of fabrics does not change as the system of collateral circulation works. In this phase endarteritis symptoms do not appear yet, but the disease already progresses.
• Phase of a spasm of large vessels. The gleam of arteries is narrowed, the system of collateral circulation does not cope with the increased loading, and such symptoms as a cold snap of extremities, fatigue and the alternating lameness appear. Treatment of an endarteritis usually begins in this stage of a disease.
• Phase of growth of connecting fabric. Because of the progressing development of connecting fabric in all layers of a vascular wall and near vascular cellulose onychalgias at rest and decrease in a pulsation on arteries appear. It is far come stage of an endarteritis of the lower extremities.
• Phase of a full obliteration of vessels or their thrombosing. It is a stage of an outcome of an obliterating endarteritis. As a result of these processes irreversible effects – a necrosis of soft tissues and gangrene develop in extremities.

At late stages of a disease characteristic changes of vessels can be met in all internals, including heart and a brain.

Diagnosis of an endarteritis of the lower extremities

As soon as there are endarteritis symptoms, it is necessary to see a doctor – the surgeon. By means of modern methods of a research the doctor will be able to make the correct diagnosis and to appoint treatment. Apply a volume sfigmografiya (measurement of a pulsation), ultrasonic doppler sonography, a reovazografiya and a X-ray contrast research of vessels of the lower extremities to installation of the diagnosis of an endarteritis.

Treatment of an endarteritis

Obliterating endarteritis – a disease for which treatment the modern medicine has not enough means and methods. For today it is impossible to achieve involution of connecting fabric, it is only possible to slow down process of its education and to facilitate a condition of the patient.

Indispensable condition of treatment of an endarteritis is the full refusal of the patient of smoking and alcohol intake as these substances promote a long vasospasm and aggravate a state.

The special diet is not shown to the patient with an endarteritis, however, it is not necessary to overeat as excess body weight creates additional load of the lower extremities. Patients with an excess weight are recommended to lose weight, and for this purpose to reduce the daily caloric content of food and to exclude farinaceous, fat and sweet dishes.

At an endarteritis of the lower extremities it is useful to move much, in day it is necessary to go on foot not less than an hour, despite of attacks of the alternating lameness. When developing pains it is necessary to stop and wait until it ceases absolutely. Driving the bicycle and swimming in water with a temperature not lower than 22-24 degrees will do good.

The patient with an endarteritis needs to watch a hygienic condition of legs – before going to bed to wash them with warm water with soap, to wipe dry and to grease with fat cream.

If these methods do not help, symptoms of an endarteritis accrue, and the condition of the patient worsens, it is necessary to resort to surgical methods of treatment of an endarteritis:

- A sympathectomy – removal in a boundary sympathetic trunk of the second and third lumbar ганглиев that leads to paretic expansion of collateral vessels and improvement of blood supply of an extremity.

- Shunting – creation of a vascular anastomosis bypassing an affected area of an artery. It is one of the most effective methods of treatment of an endarteritis.

- A thrombinthymectomy – removal of the blood clot blocking a gleam of the vessel struck with an endarteritis together with patholologically the expanded intima (an internal cover of an artery).

- Amputation of an extremity – this last resort is carried out when in the outcome of an obliterating endarteritis the necrosis of soft tissues and gangrene of an extremity develops, and also the patient is constantly tormented by intolerable pains.

Not to allow this sad outcome, the timely address to the doctor, careful observance of all its recommendations and maintaining a healthy lifestyle is necessary.