×

ARTERY DISEASES

and treatments

Peripheral artery disease

The thickening of the artery wall causes a constriction on the inside of the arteries that transport the blood to the head, organs and limbs. This wall thickening, called plaque, is composed of fat, cholesterol, calcium, fibrous tissue and other components of the blood.

When plaque grows in the arteries, one speaks of atherosclerosis. Over time, this plaque will harden and narrow the arteries. This hinders the transport of oxygen-rich blood to the organs and all parts of the body.

Peripheral artery disease is most common in the arteries to the legs but can also cause problems in the arteries that transport the blood to the head, arms, kidneys and intestines. We will limit ourselves here to atherosclerosis that affects the circulation to the legs.

The illustration shows how peripheral artery calcification can affect the arteries leading the blood to the legs. Figure A shows a normal artery with normal blood flow. The small drawing is a cross-section of a normal artery. Figure B shows an artery with plaque, which partially prevents the blood flow. The small drawing is a cross-section of a narrowed artery. Depending on the location of the constriction, different symptoms can occur.

Peripheral artery disease

A normal artery compared to an artery with plaque

Diseases

Claudication

Due to the constriction of the blood supply to the lower limbs, depending on the place where the blood vessel is constricted, you may experience stiffness to pain in the lower legs, upper legs, buttock muscles. These complaints occur every time after walking a certain distance or get worse when climbing stairs or walking uphill. They are the result of a lack of oxygen in the muscles of the affected limb due to the constriction or blockage of the artery, as a result of which the patient needs to stop walking for the pain to disappear. Walking can be resumed after a few minutes.

The medical term for claudication is “claudicatio intermittens”. In Dutch, the term “shop window legs” is used, because people who suffer from this typically stop at a shop window and thus give their muscles time to rest until they have enough oxygen to start walking again.

  Diagnosis

The diagnosis is made by duplex ultrasound examination and confirmed by an MRI examination of the arteries. This examination also gives us an important indication as to our means to remedy your condition.

  Treatment

Almost all artery diseases are nowadays treated in day-case hospitalisation under local anaesthesia, with balloon catheters and usually placement of a stent.

Oxygen deficit in the brain

Our brain gets its blood mainly through the larger carotid arteries that run vertically from behind the collarbone to the skull base on the right and left side of the neck. The medical term for these blood vessels is arteria carotis. Halfway between the collarbone and the base of the skull, this blood vessel splits into a branch leading to the face and a branch that runs to the brain. This splitting is a preferred site for arterial calcification which can lead to arterial constriction.

Oxygen deficit in the brain due to the constriction of the carotid arteries may be a possible cause of a TIA (transient ischemic attack) or a CVA (cerebrovascular accident). Patients often previously have "warnings" that are an indication of possible problems with the supply of blood to the brain. Examples include temporary visual disorders, speech disorders, word finding disorders, loss of strength in an arm or leg, skewed position of a corner of the mouth, sensory disorders in a part of arm or hand, leg or foot.

  Diagnosis

Diagnosis is performed by means of a duplex ultrasound examination. In order to evaluate the therapeutic possibilities, an MRI examination of the neck vessels is usually carried out.

  Treatment

Almost all constrictions on the carotid artery are treated today under local anaesthesia, in day-case hospitalisation, with balloon dilatation and stent placement, whereas previously this could only be remedied by an incision in the neck.

Aneurysm

A weakening in the wall of the artery can cause a bladder-shaped dilation or "aneurysm" of the artery. The most common place where such aneurysm occurs is the abdominal artery or aorta. As the diameter of the artery increases, its wall becomes thinner and the risk of "artery fracture" increases. For the abdominal artery, the limit of the diameter for treatment of the aneurysm in a woman is 5 centimetres, in a man 5.5 cm.

Theoretically one can develop an aneurysm on every artery, but the abdominal artery or aorta, and the artery in the knee fold, are most frequently affected.

  Diagnosis

Diagnosis is made by duplex ultrasound examination, confirmed by MRI or CT scan. Based on these results, we can determine whether the diseased blood vessel can be treated with a stent (endoprosthesis) or whether classical surgery is required.

  Treatment

In most cases, treatment is performed with endoprosthesis, which is minimally invasive, is done through the groin and requires two days of hospitalisation.

Dysfunction of the kidney and therapy-resistant hypertension

Constriction of the arteries leading to the kidneys can result in a decrease of the kidney function, or to high blood pressure levels, difficult to control with medication as the kidney plays an important role in the regulation of our blood pressure.

  Diagnosis

Diagnosis done through a duplex ultrasound examination. We evaluate possible therapies through an MRI-examination.

  Treatment

Almost all these constrictions can be treated with balloon dilatation and stent placement from the groin, wrist or elbow artery.

Haemorrhage of the arteries

Examples are bleeding in the pelvis after childbirth, bleeding in the pelvis after trauma, bleeding of the gastro-intestinal tract.

  Treatment

Catheter techniques are very important in the treatment of bleeding from an artery. While these problems used to require heavy surgical treatment to save the patient's life, they are now minimally invasive with catheters under local anaesthetic (embolization technique) from the inguinal or arm artery.

Arteriovenous malformations

Before the blood returns from the artery to the veins that carry it back to the heart, a whole path is made through the tissues. Congenital disorders or tissue injuries can cause defects in the blood pathway through the tissues. This is called arteriovenous defects or malformations. These defects have as symptom the observation of a typical "heart murmur" or noise or vibration at the place of the malformation.

  Treatment

Most of these defects are treated today with catheter techniques, under local anaesthesia and in day hospitalisation.

Copyright © all rights reserved
Designed by willem Jochems