ADVANCED FOOT AND ANKLE SPECIALISTS, PA
Jay S. Weingarten, DPM, FACFAS, FACFAOM
Podiatric Physician and Surgeon
Board Certified Physician – Treating Pediatrics to Geriatrics
Circulatory disorders of the lower extremities
Blood, rich in nutrients and oxygen, moves through the arteries in the direction from the
heart to the organs and tissues. If blood flow in arteries, supplying lower limbs, due to the
progression of atherosclerosis is violated, then their tissues receive enough oxygen and
nutrients and develops the disease, called «peripheral arterial disease», or the «disease of the
arteries of the legs».
Violation of blood circulation in the lower extremities may occur feeling of discomfort or
pain while walking. Pain may occur in various areas of the lower extremities: the sole of the
foot, the shins, knees, thigh, waist, depending on the damage to the various departments of
the arteries.
The risk of development and the first occurrence of the first clinical signs increases with
age. In the age group over 70 years of peripheral arterial disease suffer one of three people.
Smoking or having diabetes increases the risk of development of this disease.
Symptoms of poor circulation in the lower extremities:
It should be remembered that in rare cases, disease peripheral arteries of the lower limbs
may be asymptomatic. The most common symptom of this disease, intermittent
claudication. Intermittent claudication is discomfort or pain in the lower extremities, which
arise when walking and disappear on its termination. Sometimes You may not feel
expressed pain, but at the same time, You can greatly disturb the sense of weight, muscle
cramps or weakness in the lower extremities. More quickly intermittent claudication occurs
when lifting up. The progression of the disease intermittent claudication is beginning to
occur to all over smaller distances.
Critical ischemia of lower extremities occurs when a strong violation of blood supply of
tissues of the lower extremities. Due to the tissue of the lower extremities receive enough
oxygen and nutrients, therefore, there is a painful feeling expressed intensity, with the
localization of the hip and to the tips of her fingers even at rest, and growing at a minimum
the physical load on the lower limbs.
With a severe degree of ischemia of the lower extremities may cause dryness of the skin,
lower their temperature, pallor, as well as the emergence of trophic ulcers, expressed
painful. In the absence of treatment will inevitably develops necrosis of soft tissues and
gangrene of lower extremities.
At the present time in the world there are more than 150 million diabetes mellitus patients.
The use of insulin and other hypoglycemic agents helped to significantly reduce mortality
from metabolic complications and in the first place, among the deadly complications of
diabetes, came out of the cardio-vascular complications.
In diabetes mellitus type 2 the defeat of arteries of lower extremities occurs in 3-5 times
more often; the people free from the endocrine diseases. This fact allowed to assume that
there is a genetic connection between diabetes and atherosclerotic processes in the arteries.
The atherosclerosis in diabetes mellitus much more aggressive, the frequency of critical
ischemia considerably higher than in the rest of the population, About 40-50% of
amputations of lower extremities on the arterial insufficiency perform in patients with
diabetes.
The defeat of vessels in diabetes is divided into macroangiopathy (artery) and
microangiopathy (capillaries and arterioles). Reduction of blood flow in the microvascular
the mainstream on the background of destruction as the main arteries, and capillaries, leads
to the development of ossification of the plots of the soft tissues of the foot. Contributes to
this process of reduction of immunity and the acceding infection. The simultaneous
presence of pathology of blood vessels, diabetic nerve damage, trophic disorders of the foot
and its deformation caused the emergence of a specific term - "diabetic foot".
Risk factors of disorders of blood circulation in the lower extremities:
- Smoking;
- Insular diabetes;
- High blood pressure;
- High cholesterol or triglycerides;
- High level of homocysteine (an amino acid that is present in the blood);
- Excess body weight more than on 30%.
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