Arterial Occlusive Disease: When the Arteries Become Clogged

Everyone knows the nasty consequences of arteriosclerosis on the heart and brain: heart attacks and strokes are life-threatening, common diseases that everyone fears at an advanced age. But arteriosclerosis also leads to serious diseases in the abdominal and leg arteries. This is when we speak of arterial occlusive disease (AVD) or, more correctly in relation to the extremities, peripheral arterial occlusive disease (PAVD).

What is arteriosclerosis?

Arteriosclerosis is a hardening and narrowing of the arteries, the blood vessels that carry blood away from the heart, that occurs over years or decades. The narrowing of the arteries results in reduced blood flow and oxygen supply to the organs and parts of the body. Unfortunately, it is still not known exactly why atherosclerosis develops, but there are certain risk factors that lead to atherosclerosis more quickly.

How does atherosclerosis develop?

Arteriosclerosis does not develop overnight, but rather insidiously and undetected. Before the first symptoms appear, 20 to 40 years can pass – but they are then already of a serious nature. The clogged blood vessels lead to the affected organ being poorly supplied with oxygen under stresspain is the result. In the heart, this symptomatology is called angina pectoris; in the gastrointestinal tract, severe abdominal pain occurs after a meal, so-called angina abdominalis. In extreme cases, arterial occlusion occurs, leading to a heart attack, intestinal infarction or stroke. This is because arterial occlusive disease caused by arteriosclerosis affects not only the heart and brain, but all the arteries of the body, and especially often the arteries that lie below the diaphragm: the abdominal, pelvic and leg arteries.

How common is arterial occlusive disease?

In Germany, approximately 4.5 million people are affected by AVK. Meanwhile, one in ten people between the ages of 55 and 65 suffers from arterial occlusive disease, and after the age of 65, as many as one in five is affected. Approximately 80,000 people are constantly under medical treatment for AVK, and amputation must be performed on about 35,000 people each year because the tissue, which no longer has blood supply, would otherwise lead to life-threatening blood poisoning.

What are the manifestations of AVC?

AVC does not cause symptoms until it reaches an advanced stage. Doctors divide AVC into four stages:

  • In the first stage, a narrowing of the arteries can be detected with imaging techniques – but the patient does not notice anything yet, because the blood flow is still sufficient even under stress of the affected arteries, for example, when walking for a long time.
  • In the second stage, pain occurs during prolonged exercise, forcing the affected person to stop in the case of narrowed leg arteries. This stage is also called shop window disease (Claudicatio intermittens). At the latest now you should become active to stop the progression of AVK.
  • In the third stage, the pain also occurs at rest, and often at night, when the legs are elevated and gravity can not support the blood flow in the arteries.
  • In the fourth stage, blood flow is so reduced that the affected tissue dies. This usually affects the most distant parts of the body, i.e. the toes.

That the circulatory disorders affect not only the muscles, but all body tissues in the affected area, you can also see, for example, the changes in the skin such as healing disorders and a decrease in hairiness.

Narrowing of the arteries in the gastrointestinal tract.

A massive narrowing of the arteries in the gastrointestinal tract, on the other hand, can be compensated for a long time by the body, because fortunately there are connections between the individual arteries, so that if one artery is severely narrowed, the blood can still reach the intestine, which is sensitive to oxygen deficiency, via others. But the consequences of a massive lack of oxygen can be life-threatening. Since blood flow to the intestine is particularly required after eating because of the absorption of food components, painful colic occurs in angina abdominalis if the intestine is unable to perform this task.It becomes life-threatening for the affected person if a narrowed abdominal artery becomes completely blocked, the other arteries are unable to transport oxygen and the intestine dies. It must be removed as quickly as possible, otherwise the dead tissue will cause a dangerous peritonitis affecting the entire abdominal cavity. The necessary major abdominal surgery is then an emergency operation and carries a high risk for the affected person.