Extremity ischaemia (Ischemia) - Description and treatment

Do you feel the sensation of cold limbs? Does pain make you take breaks while walking and with time wake you up from sleep? Then you are probably affected by ischemia. It may result in tissue necrosis and creation of ulcers. In final stages, the limb might be in danger of amputation.

Warning:Do not use this or any other article on the internet to diagnose yourself. Only physicians can correctly diagnose patients. Do not postpone seeing your physician to resolve your health issues in time.

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Ischemická choroba končatín - popis a liečba - popis diagnózy a léčba
Picture : Extremity ischaemia (Ischemia)

Characteristics of Extremity Ischemia and its Causes

Extremity Ischemia causes an insufficient supply of oxygen and nutrients to the muscles and tissues. Ischaemia has the effect where limbs are not properly blood perfused, which, along with other factors and tendencies, leads to frequent necrosis. This results in a variety of trophic changes, which may lead to amputation of a limb.

With lower extremity ischemia, the disease affects arteries in legs and causes a narrowing or occlusion of the arteries.

The most common cause of narrowing or occlusion is atherosclerosis (hardening of the arteries), thrombus (blood clot), Buerger’s disease, and vasoconstriction of arteries.

Upper extremity ischemia is far less common than the lower extremity one; Raynaud’s phenomenon, a disease often called “white fingers,” is a common form.

Acute extremity ischemia is symptomized by sudden and severe pain in the limb, paleness of the limb with no swelling, impalpable pulse beyond the occlusion of the artery, impossibility to move the limb and altered sensation.

The main risk factors in developing the disease are:

  • smoking,
  • lack of exercise,
  • advanced age,
  • psychological stress,
  • obesity,
  • high level of cholesterol,
  • high blood pressure,
  • diabetes and others.

Extremity Ischemia Treatment – Rid yourself of the Pain

This disease requires specialised vascular examination and timely start of treatment based on the stage and location of the disease. The main goal is to improve arterial blood circulation and to avoid amputation. Vascular surgery plays an important role. Its goal is to attain sufficient blood perfusion in the injured limb and to make the bloodstream unobstructed (angioplasty, bypass…).

From the long-term point of view, adjustments to the lifestyle and elimination of risk factors like smoking, stress, weight reduction and managing diabetes are important.

The main goal of pharmacological treatment is to reduce platelet aggregation and creation of blood clots (antiaggregation therapy). Some drugs can directly affect arteries and cause their dilation (vasodilation drug and infusion therapy).

Acute extremity ischemia requires immobilization, covering and bracing the limb, administering heparin, analgesics and calming the patient.

In cases where there is a defect on the limb, wound healing tools and methods are utilised. Moist wound healing and physical therapy are some of those tools.

  • Trophic changes – changes to the skin (skin is drier, colder, peels, skin defects develop, there is local hair loss,..).
  • Buerger’s disease (Thrombangiitis obliterans) – diseased characterised by inflammation of arteries and veins in lower and upper limbs (mainly in smokers).
  • Vasoconstriction or constriction of vessels – process, where vessels get constricted, affects mostly arteries and veins.
  • Atherosclerosis – hardening of the arteries as a result of plaque building up in arterial walls.
  • Moist wound healing – a method of wound treatment based on creating optimally moist environment on the wound.

Regular physical activity and rehabilitation is of importance with the goal of improving microcirculation – to affect microangiopathy – dilating capillaries and pre-capillaries, and improving transfer of oxygenated blood and nutrients directly to working muscles and tissues.

Within the rehabilitation treatment low-frequency pulsed magnetic therapy has its place in treating some symptoms of limb ischaemia as it utilises the vasodilating, analgesic and healing effects with the support of anti-inflammatory effect. It does not affect dilation of medium and large arteries -the above mention antiaggregation infusion or surgical treatment is necessary here.

Magnetic therapy significantly improves microcirculation of oxygenated blood in the affected areas of the limb through the vasodilating effect targeting capillaries and pre-capillaries. It accelerates healing of damaged tissue and helps bring general relief.

Home applications are a huge convenience which allows the patient to continue intensive rehabilitation at home, out of hospital facilities.

The possibility of a secondary, long-term promotion of blood perfusion through vasodilation from the first signs of the disease is a benefit.