13 May 2020 Author : Mário Marques Vieira Peripheral arterial disease is estimated to affect up to 10% of the population aged 60 years, increasing to more than 15% after age 70. This disease is characterized by progressive obstruction of the arteries, most often of the lower limbs . It is responsible for most cardiac events (acute myocardial infarction) and cerebrovascular events (stroke). Thus, in people with peripheral arterial disease, the risk of death increases by up to 25%. Causes and risk factors The most common cause of peripheral arterial disease is atherosclerosis , an inflammatory disease that causes deposition of fat and calcium in the arteries wall. The most common risk factors , which can increase the risk of developing the disease up to 11 times, are: Being male; Arterial hypertension; High values of blood lipids or dyslipidemia; Smoking; Diabetes; Chronic renal failure. Diagnosis and treatment of peripheral arterial disease Early diagnosis and treatment are decisive for the possibility of recovery and prognosis of the disease. In the early stages, peripheral arterial disease is usually asymptomatic or causes pain in the leg calf and lameness with walking, which relieves with rest. These symptoms are due to ischemia (insufficient arterial blood flow) induced by exercise and reversible with rest. In advanced stages there may be pain in the foot at rest, due to irreversible ischemia, or even wounds and gangrene. The risk of amputation in these advanced stages of the disease increases by 30% per year, especially in the presence of infection. Treatment can range from regular walks and control of risk factors in the early stages, to specific medication (for example with aspirin, statins, antibiotics, among others) and surgical treatment in advanced cases. Until a few years ago, severe cases of peripheral arterial disease with surgical indication were submitted to classic, open, bypass surgery to resolve obstructions in critically ill patients. With the development of endovascular techniques and devices, it is now possible to treat many of these patients with minimally invasive procedure s. The results of these approaches are like those of classic surgery, but the morbidity and mortality risks are lower. In diabetic patients , in whom peripheral arterial disease has a preferential location below the knee and who often cannot undergo open surgery, these new techniques are today essential and definitive solutions for the treatment of wounds, with excellent immediate results. The evolution of ultra-thin materials, drug-eluting technologies, ultra-flexible and biomimetic stents, accompanied by state-of-the-art imaging devices, available on the Hospital da Luz network, combined with vascular surgery teams with recognized experience, allows us to respond and treat a wide range of patients, significantly reducing the amputation rate and promoting the quality of life and autonomy of patients. Meet the vascular surgery team from Hospital da Luz. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
