Angiopatiya

Description:

Angiopatiya is a group of diseases of which defeat of a vascular wall is characteristic. Disturbance of a tone of a vascular wall owing to disturbance of neurohumoral regulation is characteristic of this pathology. At an angiopatiya temporary spasms and paresis of vessels develop. As a result permeability of a vascular wall increases,  often there are hemorrhages.

At a diabetic angiopatiya defeat of a vascular wall is caused by metabolic disturbances.  There is a thickening of basal membranes of walls of vessels, proliferation of their endothelium. The artery gleam is narrowed. Microcirculation in krovosnabzhayemy fabrics is broken and ischemia (a lack of oxygen) develops. Against the background of such pathological processes are created favorable a condition for development of atherosclerotic process.

Types of an angiopatiya:

Depending on diameter of the capillaries struck by pathological process allocate the following types of an angiopatiya:
The macrovascular disease – develops at atherosclerotic defeat of vessels. Has a heavy current. A macrovascular disease as a rule develop in vessels of heart and the lower extremities.
Mikroangiopatiya – means the defeat by pathological process of small vessels developing as a result of a necrosis, thrombosis, a hyalinosis, fibrinoid swelling. Refer defeats of vessels of a mesh cover of an eyeglobe, and also defeat of capillaries of kidneys to mikroangiopatiya.
Most often the diabetic angiopatiya developing at patients with a diabetes mellitus meets. Defeat of vessels can have different localization. Most often are surprised:
Vessels of kidneys (diabetic nephropathy);
Retina vessels (diabetic retinopathy);
Vessels of the lower extremities.

Also allocate a hypertensive angiopatiya. This disease develops in the course of progressing of an idiopathic hypertensia and is most brightly shown naglazny day. At an opposite state (hypotonia), the hypotonic angiopatiya of a retina develops.

The Dizorichesky angiopatiya of Morel develops at Alzheimer's disease and senile dementia. Formation of senile plaques is characteristic of this disease combinations of an amyloidosis of walls of arteries and arterioles. Allocate two forms of a disease: druzovidny and kongofilny.

Preferential at young men the disease of Il or a proliferating retinitis develops. Development of a cataract, multiple retinal apoplexies and a vitreous is characteristic of this disease. When progressing a youthful angiopatiya there is glaucoma and there is a peeling of a mesh cover of an eyeglobe.

Angiopatiya reasons:

It is possible to carry the following factors to the reasons of development of an angiopatiya:
Disturbance of nervous control of a tone of a vascular wall;
Traumatic damages;
Blood diseases;
Smoking;
Harm on production;
Arterial hypertension;
Advanced age;
Diabetes mellitus;
System vasculites of autoimmune character;
Intoxications;
Inborn features of a structure of a wall of vessels (for example, telangiectasias).

Aniopatiya symptoms:

Manifestation of an angiopatiya first of all depend on the place of localization of pathological process. It can be noted:
Decrease in visual acuity;
Sight loss;
Onychalgias with development of "the alternating lameness" when pain arises when walking and abates after short rest;
Burning sensation, an itch in legs;
Emergence of petechias, telangiectasias on skin;
Frequent and persistent nasal bleedings;
Pneumorrhagia;
Gastrointestinal bleedings;
Hamaturia (emergence of blood in urine);
Trophic disturbances on the periphery from dryness and a peeling of skin on extremities to a foot gangrenosis.

Diagnosis:

At the address of the patient with suspicion on existence of an angiopatiya physical inspection, a palpation, percussion, auscultation, collecting complaints of the patient and the anamnesis of a disease is performed.
Then for specification of the diagnosis several researches are appointed:
Ultrasonic examination of vessels – is conducted the Doppler research and duplex scanning giving information on a condition of a vascular wall and speed of a blood-groove.
Fundus-grafiya – is applied to an eyeground research. In the received computer picture vessels of a mesh cover of an eyeglobe are visualized.
The angiography – it a retgenologichesky research begins with introduction to a radiopaque substance vessel gleam. Then a series of pictures by means of which it is possible to estimate passability of a vessel, contrast advance speed is carried out.
The magnetic and resonant tomography – this method of a research which is not bearing dose loading of radiation allows to visualize a structure of soft tissues of an organism on the monitor screen.
The computer tomography – is directed to receiving layer-by-layer pictures from area of pathological process.

Treatment of an angiopatiya:

In Israel approach treatment of an angiopatiya strictly individually, considering the nature of a disease at each patient and severity of process:
Medicamentous therapy – is directed to improvement of microcirculation in fabrics. Vasoprotectives, anticoagulants, spasmolysants, dezagregant, the drugs normalizing coagulability of blood, improving blood circulation in brain vessels are applied. An insulin therapy for the purpose of correction of level of glucose in blood is applied.
Physical therapy – for correction of a state at an angiopatiya use of a plasma exchange, electrotreatment, mud cure is shown.
Surgical treatment – has several directions. At early stages of development of a disease effective is a lumbar sympathectomy when which performing advantage is given to an endoscopic technique of conducting operation. Weakening of sympathetic influence on a wall of an artery leads to elimination of a spastic component of a pathogeny.

Various reconstructive operations on vessels recovering their gleam and improving microcirculation in fabrics are performed.

In the started cases of a current of a diabetic angiopatiya of vessels of the lower extremities with development of wet gangrene, symptoms of intoxication amputation of extremities at various level is carried out. After carrying out such injuring, but necessary operation for the patient the prosthesis allowing to make the sufficient volume of active movements is selected or made individually.

At a retinopathy cryosurgical or laser electrothermic coagulation is applied.

At atherosclerosis endarterectomy, chrezkozhny edovaskulyarny balloon angioplasty, stenting are used.