Occlusion (vascular obstruction) is a serious manifestation of vascular insufficiency. Symptoms and treatment of occlusion of blood vessels and arteries

The medical truth says: As long as a person’s blood vessels are healthy, this means that he himself is healthy. And this is an indisputable fact. After all, our body is enveloped in a large number of vessels and arteries, with a total length of one hundred thousand kilometers. Occlusion of blood vessels in the lower extremities, retina, brain and heart is by far the most common disease, the outcome of which is often fatal for humans.

Vascular occlusion is a disease in which the patency of blood vessels is impaired. And this happens due to the fact that in some area the passage of the lumen is closed. It can occur at the very different areas body: on the limbs, on the neck, on the brain, on the heart or at the retina of the eye. It all depends on the location of the damaged vessel.

Vascular occlusion can be classified according to different parameters.

If you look at the type of vessels that are damaged, there are 2 types of vascular occlusion:

  1. Venous.
  2. Arterial.

If you look at the location, then vascular occlusion happens:

  • Affects nutritional organs,
  • Affecting the great vessels,
  • Affects the central nervous system
  • Occlusion that affects the lower extremities.

The most common vascular disease affects the lower extremities; a rarer occurrence is occlusion, which affects and affects the vessels of the central nervous system and.

Reasons

There are a number of reasons that can ultimately lead to one or another type of vascular occlusion.

The causes of vascular occlusion can be very different:

  1. Embolism- this is what is called a dense formation that is located in the bloodstream. The occurrence of embolism depends on various reasons. But the first place among the causes of embolism is infection. There are 3 types of embolism.
  • Air.
  • Arterial.
  • Fat.

The next reason that can lead to vascular occlusion is thrombosis.

  1. is a process where blood clots on the inner walls of arteries constantly increase, since the lumen of the artery is reduced. This reason in itself is also the reason for the patient to develop an embolism, which can ultimately lead the person to an aneurysm.

With occlusion of cardiac vessels, death can occur suddenly and quickly as a result of the development of thrombosis in the vessels. But there are also cases when the disease develops over time and the heart muscle weakens over time. In this case, the disease lasts a long time and gradually exhausts the patient.

The most common symptom, which will let you know that you have occlusion of the heart vessels, is. These pains do not go away even after using medications.


Neck occlusion

With occlusion vertebral artery(neck) symptoms are very similar.

The first symptoms of cervical vascular occlusion:

  • Pain.
  • No pulse.
  • The presence of pallor of the skin and face. The reason for pallor is that the patient's skin does not receive the nutrition it needs.
  • Also the skin is very dry.
  • Wrinkles appear.
  • Possible (blue discoloration).

If a person does not receive timely medical care, this condition can lead to paralysis.

This type of disease is more rare, but there is still a possibility of cerebral vascular occlusion. With this type, large vessels are affected, which are responsible for delivering nutrition: blood to the human brain. Carotid artery occlusion is common.

With vascular occlusion of the brain it is noticeable sudden violation brain nutrition, and due to lack of oxygen slow down mental activity person. All this leads to the fact that the patient may develop a heart attack.

Occlusion of the vessels of the head can ultimately lead to problems throughout the body, since the organ responsible for correct work The human brain is no longer able to nourish and properly function the work of the entire organism.

Typically, the following symptoms are a signal of the disease:

  • Numbness of half the face and fingers.
  • There are disorders and deterioration of vision in the side where there is a lesion.
  • Some patients experience dizziness.
  • There is a fuzzy consciousness.
  • Dementia may set in.

It is important to note that when the vessels in the neck and head are blocked, the symptoms progress very quickly. Therefore, knowledge of symptoms and fast response on them in the form of an ambulance medical care is vital. After all, the first minutes and hours often decide everything. It’s not for nothing that in medicine the first 3-4 hours are called the “Golden Hour”.

People aged 40-65 years are most susceptible to vascular occlusion. Therefore, annual examination is vital for people who have reached this age.

Diagnostics

To diagnose vascular occlusion it is necessary to undergo full examination, which includes a number of tests: urine, cholesterol levels in the body and also ECG, MRI, CT, Dopplerography of the neck and other types of examination. Afterwards the doctor can, seeing big picture and knowing which vessel is blocked, prescribe treatment for vascular occlusion. Depending on the type and complexity of vascular occlusion, the doctor’s prescription can be very different.

Anticoagulant therapy is considered the most important in treatment. An important point in the treatment of vascular occlusion is to avoid the complications that often accompany the disease. After all, due to circulatory disorders, a number of problems can arise in different parts and organs. That is why the patient is prescribed a course of direct anticoagulants in the form of injections. A course may also be prescribed indirect anticoagulants in the form of tablets.

If the case is serious and very advanced, and treatment of blood vessels with medications does not produce results, then thrombectomy is prescribed. This is a surgical intervention and in 90% of cases gives excellent result, if done in initial stage occlusion. Unfortunately, it happens that patients suffer from pain and constantly postpone the examination. In this case, the outcome is often fatal. Therefore, it is important to remember that health is not something to joke about.

If there are any problems or the symptoms listed above are present, you should immediately go to a specialist and undergo a full medical examination.


Prevention

The most important thing in vascular occlusion is, perhaps, prevention done on time. Since everyone has long known that it is better and easier to prevent the onset of a disease than to try to treat the disease later.

Prevention of such a serious and complex vascular disease includes a number of simple actions, namely:

  • - By this we must understand: reducing fatty foods, as well as foods with high content cholesterol, minimizing the amount of sugar and salt in daily ration. It is also important to remember that proper nutrition contains a number of vitamins and beneficial macro and microelements, which are necessary both for the whole body and are indispensable for blood vessels.
  • Reducing alcohol and nicotine intake – Alcohol and nicotine are two enemies of the body. They have a detrimental effect on the entire body. Ideally, it would be better if a person could avoid them, but if this cannot be done right away, then at least reducing the amount is simply necessary.
  • Physical activity - As the old saying goes: “Movement is life!” And today everything is leading to the fact that people move less and less. And about physical activity and everyone has completely forgotten the exercises. Everyone should engage in active physical activity, in accordance with their age.
  • Weight - overweight is unacceptable, as this can often cause various problems with blood vessels.

Partial or complete obstruction of the lumen of the carotid arteries supplying blood to the brain. May have asymptomatic, but is more often manifested by repeated TIAs, clinical manifestations of chronic cerebral ischemia, ischemic strokes in the middle and anterior cerebral arteries. Diagnostic search for occlusion carotid arteries aimed at establishing the location, genesis and degree of obstruction. It includes ultrasound of the carotid vessels, cerebral angiography, magnetic resonance angiography, CT or MRI of the brain. The most effective surgical treatment consists of endarterectomy, stenting the affected area of ​​the artery, or creating a vascular bypass graft.

Occlusion of the carotid arteries can be partial, when only a narrowing of the lumen of the vessel occurs. In such cases, the term “stenosis” is more often used. Complete occlusion is obstruction of the entire diameter of the artery and when acute development often leads to ischemic stroke, and in some cases to sudden death.

Anatomy of the carotid artery system

The left common carotid artery (CCA) starts from the aortic arch, and the right one starts from the brachiocephalic trunk. Both of them rise vertically upward and in the neck area are localized in front of the transverse processes of the cervical vertebrae. At the level thyroid cartilage each CCA is divided into the internal (ICA) and external (ECA) carotid arteries. The ECA is responsible for the blood supply to the tissues of the face and head, other estracranial structures and parts of the hard meninges. BCA through channel in temporal bone passes into the cranial cavity and provides intracranial blood supply. It nourishes the pituitary gland, frontal, temporal and parietal lobes of the brain of the same side. The ophthalmic artery gives off blood supply from the ICA various structures eyeball and eye sockets. In the area of ​​the cavernous sinus, the ICA gives off a branch that anastomoses with the branch of the ECA passing to inner surface skull base through hole sphenoid bone. Collateral circulation occurs through this anastomosis during obstruction of the ICA.

Causes of carotid artery occlusion

Most common etiological factor occlusion of the carotid arteries favors atherosclerosis. An atherosclerotic plaque is located inside the vascular wall and consists of cholesterol, fats, and blood cells (mainly platelets). As the atherosclerotic plaque grows, it can cause complete occlusion of the carotid artery. A blood clot can form on the surface of the plaque, which moves further along the vascular bed with the blood flow and becomes the cause of thrombosis of intracranial vessels. In case of incomplete occlusion, break away from vascular wall maybe the plaque itself. Then it turns into an embolus, which can lead to thromboembolism of smaller cerebral vessels.

Obstruction of the carotid arteries can also be caused by other pathological processes of the vascular wall, for example, with fibromuscular dysplasia, Horton's disease, Takayasu's arteritis, moyamoya disease. Traumatic occlusion of the carotid arteries develops as a result of TBI and is caused by the formation of a subintimal hematoma. Other etiofactors include hypercoagulable states (thrombocytosis, sickle cell anemia, antiphospholipid syndrome), homocystinuria, cardiogenic embolism (with valvular acquired and congenital heart defects, bacterial endocarditis, myocardial infarction, atrial fibrillation with the formation of blood clots), tumors.

Factors contributing to stenosis and obstruction of the carotid arteries are: features of the anatomy of these vessels (hypoplasia, tortuosity, kinking), diabetes mellitus, smoking, poor nutrition With increased content animal fats in the diet, obesity, etc.

Symptoms of carotid artery occlusion

The clinical picture of carotid artery obstruction depends on the location of the lesion, the rate of development of occlusion (suddenly or gradually) and the degree of development of vascular collaterals that provide alternative blood supply to the same areas of the brain. With the gradual development of occlusion, a restructuring of the blood supply occurs due to collateral vessels and some adaptation of brain cells to the current conditions (reduced flow nutrients and oxygen); A clinic for chronic cerebral ischemia is being formed. The bilateral nature of obturation has more severe course or less favorable prognosis. Sudden occlusion of the carotid arteries usually leads to ischemic stroke.

In most cases, occlusion of the carotid arteries manifests itself as a transient ischemic attack (TIA) - a transient disorder of cerebral circulation, the duration of which, first of all, depends on the degree of development of vascular collaterals in the affected area of ​​the brain. The most typical symptoms of TIA in the carotid system are mono- or hemiparesis and sensory disturbances on the opposite side (heterolateral) in combination with monocular visual impairment on the affected side (homolateral). Typically, the beginning of an attack is the occurrence of numbness or paresthesia of half the face and fingers, the development muscle weakness in the entire arm or only in its distal parts. Visual disturbances range from the sensation of spots in front of the eyes to a significant decrease in visual acuity. In some cases, retinal infarction is possible, triggering the development of optic nerve atrophy. More rare manifestations of TIA with obstruction of the carotid arteries include: dysarthria, aphasia, facial paresis, headache. Some patients report dizziness, lightheadedness, swallowing problems, and visual hallucinations. In 3% of cases, local convulsions or major seizures are observed.

According to various data, the risk of ischemic stroke within 1 year after the onset of TIA ranges from 12 to 25%. In approximately 1/3 of patients with carotid artery occlusion, a stroke occurs after one or more TIAs, and in 1/3 it develops without previous TIAs. Another 1/3 are patients in whom ischemic stroke is not observed, but TIAs continue to occur. The clinical picture of ischemic stroke is similar to the symptoms of TIA, but it has a permanent course, i.e., the neurological deficit (paresis, hypoesthesia, visual disturbances) does not go away over time and can only decrease as a result of timely adequate treatment.

In some cases, there are no manifestations of occlusion abrupt start and are so unexpressed that it is very difficult to assume vascular genesis problems that have arisen. The patient’s condition is often interpreted as clinical or dementia. Some authors indicate that irritability, depression, confusion, hypersomnia, emotional lability and dementia can develop as a result of occlusion or microembolism of the ICA on the dominant side or on both sides.

Obstruction of the common carotid artery occurs in only 1% of cases. If it develops against the background of normal patency of the ECA and ICA, then the collateral blood flow going through the ECA to the ICA is sufficient to avoid ischemic brain damage. However, as a rule, atherosclerotic changes in the carotid arteries are multi-level, which leads to the symptoms of occlusion described above.

The bilateral type of occlusion of the carotid arteries with well-developed collaterals may have an asymptomatic course. But more often it leads to bilateral strokes of the cerebral hemispheres, manifested by spastic tetraplegia and coma.

Diagnosis of carotid artery occlusion

In diagnosis, along with a neurological examination of the patient and the study of medical history, instrumental methods for studying the carotid arteries are of fundamental importance. To the most accessible, safe and sufficient informative method applies Doppler ultrasound of blood vessels head and neck. With occlusion of the carotid arteries, ultrasound examination of extracranial vessels usually reveals accelerated retrograde blood flow along the superficial branches of the ECA. Under conditions of occlusion, blood moves through them to the ophthalmic artery, and through it to the ICA. During ultrasound examination, a test is performed with compression of one of the superficial branches of the ECA (usually the temporal artery). A decrease in blood flow through the ophthalmic artery with digital compression of the temporal artery indicates occlusion of the ICA.

Angiography of cerebral vessels allows you to accurately determine the level of occlusion of the carotid arteries. However, due to the danger of complications, it can be performed only in difficult diagnostic cases or immediately before surgical treatment. MRA - magnetic resonance angiography - has become an excellent and safe replacement for angiography. Today, in many clinics, MRA in combination with MRI of the brain is the “gold standard” for diagnosing carotid artery occlusion.

Ischemic damage to cerebral structures is visualized using MRI or CT scan of the brain. Moreover, the presence of “white” ischemia indicates the gradual atherosclerotic nature of obstruction of the carotid arteries, and ischemia with hemorrhagic impregnation indicates an embolic type of lesion. It should also be taken into account that in approximately 30% of patients with ischemic stroke in the first days focal changes are not visualized in brain tissue.

Treatment of carotid artery occlusion

In relation to occlusion of the carotid arteries, it is possible to use various surgical tactics, the choice of which depends on the type, level and degree of obstruction, condition collateral circulation. In cases where the operation is performed 6-8 hours after the onset of progressive ischemic stroke, the mortality rate of patients reaches 40%. Due to this surgical treatment It is advisable before the development of a stroke and has preventive value. As a rule, it is performed in the intervals between TIAs when the patient’s condition is stabilized. Surgical treatment is carried out mainly for extracranial type of occlusion.

Among the indications for surgical treatment of stenosis and obstruction of the carotid arteries are: recent TIA, completed ischemic stroke with minimal neurological impairment, asymptomatic occlusion of the cervical ICA of more than 70%, the existence of sources of embolism in extracranial arteries, insufficient arterial blood supply brain.

For partial occlusion of the carotid arteries, the operations of choice are: stenting and carotid endarterectomy (eversion or classic). Complete obstruction of the vascular lumen is an indication for creating an extra-intracranial anastomosis - a new blood supply route, bypassing the occluded area. If the lumen of the ICA is preserved, subclavian-general prosthetics are recommended; if it is obstructed, subclavian-external prosthetics are recommended.

Prognosis and prevention

According to generalized data, asymptomatic partial occlusion of the carotid arteries up to 60% in 11 cases out of 100 is accompanied by the development of stroke within 5 years. When the lumen of the artery is narrowed to 75%, the risk of ischemic stroke is 5.5% per year. In 40% of patients with complete occlusion of the ICA, ischemic stroke develops in the first year of its occurrence. Carrying out preventive surgical treatment can minimize the risk of developing stroke.

Measures aimed at preventing arterial occlusion include getting rid of bad habits, proper nutrition, fight against overweight, correction of blood lipid profile, timely treatment cardiovascular diseases, vasculitis and hereditary pathologies (for example, various coagulopathies).

The cardiovascular system of the human body is the most vulnerable, therefore the number of patients with pathologies affecting it is steadily growing. The number is also increasing known to the world diseases. Every year, experts discover new forms of disorders that arise against the background of more common ailments. All of them pose a threat to human health and life, and require mandatory treatment, as well as careful study. After all, in order to pick effective methods therapy, you should initially find out the origin of the pathology and find the factors that provoked its development.

Occlusion - characteristics

Occlusion of the arteries of the lower extremities is a very serious illness associated with decreased conductivity large vessels circulatory system. That is, it is a kind of vascular insufficiency, leading to paralysis of the functioning of many body systems. Occlusion is a sudden obstruction of the arteries, provoked by pathological processes, trauma to structures or blockage by a blood clot. It is very important to have knowledge about the causes that can cause this disease, since in cases of sudden blockage of blood flow, the time to take action will be extremely limited. In addition to the arteries of the lower extremities, occlusion can also affect the main vessels that supply other organs and systems. All types of illness develop as a result of several unfavorable factors.

Causes of occlusion

  1. Embolism. It occurs as a result of blockage of the arteries by dense formations that have entered the bloodstream. This disorder can be triggered by infectious processes in which pathogens or purulent inflammatory blood clots form. There are several types of embolism that lead to occlusion: a) Air - a consequence of the penetration of an air bubble into the vessel. This can happen in case of complex injury to the lungs and other respiratory organs, as well as in cases of incorrectly performed intravenous injection. b) Fatty - appears as a result of injury and acute metabolic disorders in the body. At the same time, there are small particles of fat in the arteries, which, when combined into one whole, clog the channel, which causes occlusion. c) Arterial - the provoking factors in this situation are active blood clots. These mobile formations are localized mainly in the valvular heart apparatus. Blood clots - accompanying symptoms a number of heart pathologies. It is arterial embolism that most often becomes a precursor to occlusion. Emboli form blockages mainly in areas of narrowing and branching of arteries.
  2. Thrombosis. The lumens of large blood vessels often become clogged gradually. This is due to the accumulation and growth of blood clots on their inner walls. Thrombosis develops against the background of atherosclerosis, injury, and infection. Thrombosis is a prerequisite for thromboembolism, since in the areas where it is localized, the arteries become very vulnerable and are easily clogged. The result is occlusion of the arteries of the lower extremities and other organs.
  3. Aneurysm. An equally common risk factor for occlusion is an aneurysm. The weakening of blood vessels, their pathological expansion and protrusion, become the reason for the formation of blood clots in the affected areas (embolism, thrombosis). Therefore, congenital or acquired abnormalities of arterial tissue are among the causes of the disease in question.
  4. Damage. In case of injury, when a vessel is compressed by bone or muscle tissue, natural blood flow is disrupted in the area of ​​compression large arteries thrombosis processes begin.

Leg lesions, features

Occlusion of the arteries of the lower extremities occurs most often. In half a percent of cases, patients are diagnosed with damage to the femoral and popliteal large vessel. Signs of such a violation have been identified and studied. These include:

  • Painful sensations that spread to the entire leg area and do not subside even when changing the position of the limbs.
  • Absence of pulse in areas of the arteries close to the area of ​​localization of the occlusion (using this symptom, specialists are able to determine the exact location where the blockage occurred).
  • Pallor skin of the affected limb with the subsequent appearance of traces of cyanosis.
  • Decrease in body temperature in the area of ​​concentrated occlusion.
  • Paresthesia, that is, numbness that is clearly felt by the patient. At first, tingling and goosebumps appear, and then the leg may completely lose sensitivity.
  • Complete paralysis, the occurrence of extensive ischemia - impaired motor functions of the limb.

If a person experiences the symptoms described above, this indicates that he has occlusion of the arteries of the lower extremities and medical assistance should be taken immediately. If treatment is not started within 4-5 hours, then there is a threat of irreversible processes of necrosis (death) of vascular tissue and the development of gangrene. Such a dangerous disease, if not treated in a timely manner, causes leg amputation and disability. Are exposed this disease predominantly older men.

Prevention of pathology

Occlusion of the arteries of the lower extremities occurs as a result of fairly common diseases, so every person with problems with the cardiovascular system is at risk. To protect yourself from such dangerous disease, must be taken preventive measures which include:

  • Maintain normal blood pressure levels, do not abuse coffee, alcohol, salty and spicy foods.
  • Eat healthy and balanced, limit consumption fatty foods, sources of cholesterol.
  • Saturate the body with vitamins.
  • Monitor your body weight.
  • Stop smoking and drinking alcohol.
  • Lead an active life (play sports).
  • Avoid stress and emotional outbursts.

Occlusion of the arteries of the lower extremities is cured in most cases only by surgical intervention. Monitoring your health and maintaining your functioning cardiovascular system Normally, the need for surgery can be avoided.

Arterial occlusion is the blocking of the lumen of a vessel, leading to disruption of the nutrition of organs located in the bed of the damaged artery. The reasons may vary. It is important that the symptoms often manifest themselves acutely, require urgent treatment, and threaten dangerous consequences.

The peculiarity of the disease is the possibility clinical manifestations not near the source of occlusion, but in distant areas. Therefore, to eliminate it, it is so important to find the localization and cause of circulatory disorders, and diagnosis requires the use of methods that allow assessing blood flow throughout the entire length of the vessel.

The most dangerous are occlusal changes in the main or main arteries, nourishing the brain, heart, organs abdominal cavity, lower limbs.

What can cause occlusion?

Most common cause impaired patency of the vessel is considered an embolism. The part that becomes an embolus is:

  • a detached thrombus from the veins of the lower extremities or a parietal immobilized area of ​​the myocardium during acute infarction, in the case of aneurysmal changes in the heart and aorta;
  • adipose tissue in case of injury or surgical intervention in the area of ​​large venous branches due to their injury and a fairly strong suction effect;
  • warty deposits with microorganisms in case of septic damage to the heart valves or internal inflammation of the vessel;
  • air entering a vein during injury, catheterization of large vessels, heart cavities, or as a result of criminal acts.

The path of the embolus coincides with the capabilities of the circulatory system. The beginning of occlusion depends on where it stops.

Features of the direction of the embolus

From the veins of the legs, a thrombus or embolus moves towards the heart. It is maintained by negative pressure inside the right atrium and at the mouth of the vena cava. Passing through the right parts of the heart, the most “convenient” stopping place is the pulmonary artery or its branches (depending on the size of the embolus). Because the right ventricle pushes it through with the release of blood. Pulmonary infarction due to acute thromboembolism of the main trunk pulmonary artery is most often a fatal disease.

If a person has a patent interatrial or interventricular septum, then an additional opportunity opens up for the embolus to move to the left side of the heart and enter the arterial blood.

Bypassing the aorta, the embolus rushes at high speed into the abdominal region and femoral artery. In the same way, occlusion of the carotid arteries can occur, and through them the embolus passes further into the peripheral vessels heart, brain.

In the presence of an infectious disease with damage to the heart valves (rheumatic carditis, septic endocarditis), emboli from the left ventricle can reach the extreme points of the blood supply even in small arteries, causing occlusion of the central retinal artery or acute myocardial infarction due to thrombosis coronary vessels.

A blood clot blocking the carotid artery interferes with blood flow to the brain

What changes should be considered a risk of occlusion?

Occlusal risk is associated with various diseases. But they are all in their development:

  • violate the integrity and structure of the vascular wall (vasculitis, varicose veins, thrombophlebitis, acute and chronic infections, aneurysmal protrusions);
  • are accompanied by increased thrombus formation (blood diseases with increased coagulability, diabetes mellitus, atherosclerotic lesions, hypertension).

Let's consider the most common types of arterial occlusion.

Carotid artery lesion

Occlusion of the internal carotid artery, the largest vessel supplying the brain, is most often caused by thrombosis. Among all occlusive lesions in cardiology practice occupy 54–57%. Clinical manifestations are possible in four variants:

  • acute apoplectic form with sudden onset, coma, development of hemiplegia (immobility of half the body), convulsive seizures;
  • subacute or remitting - symptoms develop over several days or weeks, the patient is worried about dizziness, headaches, “darkening” in the eyes, intermittent weakness and decreased sensitivity in the extremities;
  • chronic or pseudotumor develops slowly, manifestations depend on the level of damage;
  • hidden - occurs without clinical manifestations, complete blockage does not occur.

The course of the disease always affects cerebral circulation, causing ischemic stroke with increasing focal neurological symptoms. They are aggravated if the embolus, caught on the wall of the carotid artery, causes the construction of a local thrombus, which enters the middle or anterior cerebral artery with a free “tail”.

According to statistics, occlusion of the carotid arteries in 56% of cases is the true cause of cerebral ischemia and causes 30% of strokes.

Damage to the vertebral artery

Occlusion of the vertebral artery most often develops in cervical spine. The disease develops slowly with periods of deterioration and improvement, but with steady progression. Share in total amount occlusions - up to 17%.

Typical symptoms:

  • dizziness, staggering when walking;
  • noise in the ear and hearing loss on one side;
  • blurred vision, double vision;
  • change and difficulty speaking.

These changes occur when the head position changes, tilts, and turns. They are associated with acute ischemia of the brain, cerebellum and occipital cortex.

Damage to the blood vessels of the eyes

Occlusion of the central retinal artery disrupts the nutrition of the layer of sensitive cells on back surface eyes. More often observed in older people. Caused by a small embolus consisting of a piece of cholesterol plaque.


The picture of the fundus during cessation of blood circulation in the central retinal artery, clinically manifested sudden loss view from one side

The danger lies in the complete death of cells within a few hours. Occlusive lesions of the retinal veins proceed more favorably. It causes swelling and blood stagnation. The treatment brings positive results.

Subclavian artery occlusion

Impaired patency in the area of ​​the subclavian artery leads to ischemia of the arms and brain. Develops with embolism in the first segment (according to various observations, in 3–20% of cases). Left artery is affected 3 times more often, since it is directly connected to the aortic arch and an embolus enters it more easily. Bilateral occlusion was found in 2% of patients.

A vertebral branch departs from the initial segment of the subclavian artery to the occipital lobe of the brain. Through it, it affects the blood supply and causes symptoms of ischemia.

The following are involved in the development of occlusion:

  • mediastinal tumors;
  • curvature of the spine due to osteochondrosis;
  • traumatic neck injuries;
  • fracture of the collarbone or first rib;
  • chest injuries;
  • congenital anomalies of the location of the aortic arch.

The characteristic symptoms are explained by the development of vertebral-basilar insufficiency of the brain, ischemia of the arms, and manifestations of steal syndrome (with high thrombosis of the subclavian artery, blood overflows the radial branch located below).

66% of patients have manifestations of brain failure:

  • dizziness;
  • headache;
  • hearing and vision impairment.

Half of the patients have ischemia upper limb with pain in the hand, cold fingers, numbness, cramps.


This is what occlusion of the mesenteric artery looks like on a diagram and angiogram

Damage to the arteries arising from the abdominal aorta

Among occlusive diseases of arteries, level lesions abdominal aorta are in second place after the coronary vessels. Most often, a disease associated with thrombosis is detected in men (90%) after 50 years of age, and embolism occurs in a rheumatic process with stenosis of the left atrioventricular orifice. The embolus “sits” on the branch of the aorta and contributes to the formation of secondary thrombosis.

Pathology of the ileum and femoral arteries called:

  • overgrowing of the vessel lumen with atherosclerotic plaques;
  • thickening of the wall due to compaction and inflammation of the inner membrane ().

With a high level of damage - at the level of the abdominal aorta - the patient experiences:

  • severe pain in the legs, which can radiate to the back, sacrum, perineum, genitals;
  • coldness of the legs with complete disappearance of the pulse on both sides;
  • increase in body temperature.

Gangrene of the legs develops quickly.

With gradual blockage, symptoms develop slowly. Patients complain of constant weakness in the legs and impaired potency.

For thrombosis of the superior iliac artery:

  • the pain is very intense, spreading throughout the abdomen, radiating to the lower back;
  • the stomach is swollen;
  • vomiting of food, bile, and rarely blood appears.

The patient falls blood pressure, peritonitis develops quickly, paralytic ileus intestines.

The level of occlusion can be determined by palpation of the pulse in the arteries of the legs:

  • if there is no pulsation in the popliteal fossa (in 80% of cases), then one should think about a higher level of damage to the femoral artery;
  • 10–15% of patients have isolated lesions tibial artery on the lower leg and foot.

The following symptoms are characteristic of occlusion of the arterial vessels of the legs:

  • the pain is at first transient, then diffuse, and is not reduced by a change in position;
  • the appearance of bluish spots on pale skin;
  • significant cooling of the skin to the touch;
  • numbness with areas of paresthesia (pins and needles);
  • paralysis of the leg.

Acute occlusion requires urgent intervention within 6 hours. In the future, gangrene sets in and amputation follows.

Diagnosis of arterial occlusion

Methods for diagnosing occlusions of various arteries include examinations by medical specialists. It is necessary to clarify the neurological pathology and identify the focality of symptoms. Cardiologists examine the heart in more detail. To diagnose central retinal artery occlusion, a detailed examination of the fundus is necessary.

In the study of the vessels of the head and extremities, the following are of great importance:

  • rheoencephalography;
  • ultrasound examination;
  • Doppler color study of blood flow;
  • angiography with the introduction of contrast agents.

To establish communication brain symptoms with damage to the adductor arteries and subsequent treatment, it is important to know:

  • which of the extracerebral vessels is damaged (carotid, subclavian or vertebral arteries);
  • how severe is the stenosis;
  • the size of the embolus or atherosclerotic plaque.

To do this, the duplex study technique uses the calculated occlusion coefficient. It is determined by the ratio of the diameter at the site of narrowing to the undamaged area. Occlusion is assessed in five degrees depending on the speed of blood flow relative to normal (less than 125 cm/sec.). Subocclusion is a pronounced narrowing of the lumen (more than 90%), this stage precedes complete obstruction.

Treatment

Treatment and prognosis for occlusive vascular lesions is determined by the form of the disease and stage. Central retinal artery occlusion is treated with laser.

From conservative methods it is possible to use fibrinolytic therapy in the first 6 hours to dissolve the blood clot.


Visual restoration of arterial patency after angioplasty

The main way is surgical methods. All operations are aimed at restoring the patency of the affected vessel and eliminating the consequences of ischemia of organs and tissues.

For this use:

  • blood clot removal;
  • creation of a bypass anastomosis or shunt;
  • resection of the damaged artery;
  • replacement of the affected area with an artificial prosthesis;
  • balloon dilatation of the artery with stent installation.

Each operation has its own indications and contraindications.

Occlusion can be prevented using available measures to prevent atherosclerosis, hypertension, diabetes mellitus. Fulfillment of requirements for rational nutrition and reception medicines significantly reduces the likelihood dangerous consequences.

The deterioration of the condition of blood vessels causes a number of dangerous diseases, the consequences of which can even result in wheelchair. A common diagnosis associated with disorders of the vascular system of the legs is occlusion of the arteries of the lower extremities. Similar situation is born as a result of blockage of the lumen of a vessel, provoked by atherosclerosis, thrombus formation, or external mechanical influence.

Causes of arterial dysfunction

Vascular occlusion does not occur without cause. There are certain factors associated with violation of the integrity of the vessels of the lower extremities:

  1. Penetration of infection. The artery becomes inflamed due to the penetration of the virus. The consequence of this is blockage of the vessel with ulcers and blood clots. This type of occlusion of the lower extremities is called “embolism”.
  2. Air entry. Clogging popliteal artery air bubbles become a consequence of incompetent intravenous infusion. The second reason for the appearance may be lung injury. This is how an air embolism appears.
  3. Excess body weight. Disruption of metabolic processes causes obesity, causing fat embolism. In this case, adipose tissue becomes the material for blocking blood vessels.

Often the cause of occlusion of the arteries of the lower extremities can be previous diseases or their consequences. These include the following diseases:

  • structural abnormalities of the heart;
  • ischemia;
  • tachycardia;
  • hypertension;
  • atherosclerosis;
  • frostbite over a large area of ​​the legs.

More often than other listed factors, the cause of occlusion of the lower extremities is atherosclerosis.

Features of the development of pathology

The beginning of occlusive syndrome is the appearance of a blood clot. As the blood clot develops, it increases in size and blocks the lumen of the vessel cavity. Such an obstacle reduces blood flow, disrupts blood clotting processes and the integrity of the tissue vascular wall.

Ischemic fluctuations of the cardiac system cause a malfunction of the body's metabolic processes, causing hypoxia and disruption acid-base balance. The result of this process is the destruction of cellular particles, characterized by external swelling and internal disruption of blood circulation in the popliteal artery.

Types of occlusal pathology

Blood clots can be localized in different parts of the vessels, blocking the blood flow pathways. Therefore, medical experts highlight the following types blockages of blood vessels in the legs:

  1. Impaired functionality of small arteries. Symptoms of the disease in this case extend to the area ankle joint. This is the most common type of occlusion.
  2. Clogging of the cavity of large arterial vessels. The iliac as well as the femoral region of the legs is affected. Occlusion of the superficial femoral artery is diagnosed.
  3. Occlusion of the popliteal artery. A combined form of the disease, including both types of disorders of the arterial system of the legs due to blockage of the vessel. Damage to the popliteal artery is considered the most dangerous form of occlusion.

Symptomatic manifestations

The most striking manifestation of occlusion of the arteries of the legs is the periodic occurrence of paresthesia and pain in the legs when walking, forcing the patient to stop. Attacks of intermittent claudication may occur after moving different distances. Limping can begin both during the first 25 meters and after many kilometers of travel. Pain in the ankle joint is often an accompanying symptom of intermittent claudication.

The disease is accompanied by a number of characteristic unpleasant sensations:

  • chilly feet;
  • rapid fatigue;
  • convulsive contractions.

Particular attention is paid to the appearance of pain at night or at other times when the body is at rest and relaxation. Such signs indicate a diagnosis of “severe ischemia of the distal limbs.” This dangerous illness, which can cause serious damage to humans.

The progression of atherosclerosis is increasing. The disease often causes gangrene of the leg, requiring surgery to amputate the limb. This becomes the only way to save the patient's life. Obliterating endarteritis is often characterized by long-term remissions.

It is customary to distinguish several stages of endarteritis:

  1. Spastic stage. Characterized by pale color superficial layer of the skin of the legs and cold feet. Standing on your feet for a long time causes fatigue in the calf area.
  2. Stage of organic changes in blood vessels. First, there is pain associated with a feeling of squeezing during movement over close distances. The legs feel stiff and there is also a slight limp. Then the pain increases and becomes unbearable. It is difficult for a person to overcome average distances. At the same time, lameness intensifies.
  3. Necrotic stage. Damage to the integrity of the epidermis is noted, characterized by trophic disorders. Are developing ulcerative formations and gangrene.

Diagnostics in medical settings

Diagnosis of thrombobliterating disorders of the blood vessels of the legs occurs during a conversation with the patient and during the implementation of appropriate procedures. The doctor pays attention to:

  1. Arterial pulse of the legs. The pulsation of the dorsal tibial artery of the outer region of the foot is expressed sluggishly or completely absent.
  2. Oscillogram. Since some percentage even healthy people may not have a pulse in the arteries of the feet; this procedure helps determine the presence of occlusal disorders.
  3. Arteriography results. Given X-ray examination arteries is carried out by introducing a radiopaque contrast agent into the lumen of the vessel. This way the nature of the occlusive lesion and its extent are clarified. Afterwards the operation is scheduled.

Only the first stage of the disease is treated with medication. Therapy is long-term and involves the use of drugs pharmacological group thrombolytics and antispasmodics. Additional treatment procedures are prescribed by a doctor. The most popular are magnetic therapy, barotherapy, and plasmapheresis.

How to prevent disease

The best way to prevent disease is reliable prevention. The complex for preventing occlusive syndrome consists of the following measures:

  • maintaining blood pressure levels;
  • preventing the development of hypertensive syndrome;
  • using fiber-rich foods in the diet, avoiding fatty and fried foods;
  • moderate exercise;
  • retention normal weight bodies;
  • fighting bad habits.

If the above signs of leg problems appear, you should immediately visit a surgeon. Timely contact with a specialist will help to avoid dangerous consequences and maintain the patient’s health.