Anyone who hears the word “infarction” immediately thinks of a heart attack. No wonder, because around 280,000 people in Germany suffer an acute heart attack every year. For 80,000 of them, help comes too late. This means that heart attacks and cardiovascular diseases are still the number one killer in Germany. However, it is less well known that all other organs can also suffer a heart attack.
Vascular damage as a cause
The principle that underlies this disease is always the same – regardless of which organ is affected. A vessel supplying the corresponding organ becomes blocked. The tissue behind it can no longer be supplied with oxygen and dies. The dead tissue scars, and waste products from this entire “remodeling process” must be removed and disposed of by the body. The vascular blockage that triggers an organ infarction is usually a blood clot that has formed on the vessel wall and is then torn off with the blood flow and transported further. Where it gets stuck, it leads to a blockage of the vessel. Such clots – also called thrombi – occur when the actually smooth walls of the vessels are roughened by deposits.
When the vessels become increasingly narrow …
The primary cause of deposits on the walls of blood vessels is arteriosclerosis, in which cholesterol deposits lead to narrowing of the vessels. This disease initially affects the entire vascular system, although narrowing in the vessels of the heart is particularly common. Nevertheless, thrombi can form anywhere in the body’s vascular system. Thus, strokes, like heart attacks, are triggered by acute vascular occlusions. The number of stroke patients is just as alarmingly high as the number of heart attack sufferers: In Germany, around 200,000 people suffer a stroke every year, which ends in death or permanent disability for 70,000.
Diabetics are particularly at risk
Vascular damage is the most significant late consequence of diabetes mellitus, or diabetes. In fact, organ infarction is the most common cause of death in diabetics, who, as a high-risk group, often also have problems with subsequent healing processes due to their overall poor circulation. Infarcted tissue is more difficult to break down and remove. Those who belong to the risk clientele of the so-called “metabolic syndrome,” which in addition to diabetes also includes high blood pressure and lipid metabolism disorders, are also considered to be at risk of organ infarction.
Eye infarcts on the rise
In addition to the heart, kidney, spleen or liver, the eyes can suffer an infarction. An ocular infarction is the formation of a blood clot (thrombosis) in the ocular artery that blocks the vessels behind it. In this case, the affected person suddenly sees nothing or only a spot in one eye. Often, the vision in the affected eye is also completely blurred. When an ocular infarction occurs, an ophthalmologist or, even better, an eye clinic should be consulted as quickly as possible – within 20 hours, in fact – otherwise the chances of recovery drop rapidly. Although the damage caused by the ocular infarction can be reduced by means of laser or acupuncture, in most cases a restriction of the ability to see remains. A new procedure has now been tested at the University of Freiburg, Germany, in which the arterial occlusion is dissolved-similar to occlusions of the coronary arteries.
New therapy
The procedure takes 1-2 hours and is performed under local anesthesia in the groin region. General anesthesia is not necessary because there are no nerve fibers on the inner walls of the vessel and the patient does not feel pain when the catheter is placed. The catheter is inserted through the inguinal artery and then slides through the aorta into the carotid artery. The ophthalmic artery branches off from here. Then the surgeon must follow the almost right-angle branch into the ophthalmic artery. The path of the catheter is followed on the monitor. Once the doctor has reached the site of the vessel occlusion with the catheter, he injects the drug that dissolves the blood clot. This delivers it in a highly concentrated form directly to the site of the occlusion. This is the advantage over the conventional method, in which the drug was distributed throughout the body via the arm vein and arrived at the site of occlusion highly diluted and thus often ineffective.
Precaution and control
Ocular infarction usually affects only one eye.This makes it all the more important to protect the second eye from infarction. To do this, the exact causes of the first infarction must be determined and any risk factors such as high blood pressure, elevated cholesterol levels and diabetes clarified. Regular ophthalmological check-ups are also part of the program. Basically, anyone who is considered a risk patient for cardiovascular disease also carries the risk of an ocular infarction.
Prevention in advance
Preventing cardiovascular disease is therefore an urgent task not only for each individual, but also for the national health care system. Just as health policy makers and physicians are striving to increase education and successful prevention programs, researchers are looking for ways to prevent vascular damage. One approach is the discovery that erythropoietin (EPO), a hormone produced naturally in the body, apparently not only stimulates blood formation but also helps repair injured blood vessels. Genetically engineered EPO could then be used for treatment. At Hanover Medical School, researchers are currently investigating the extent to which erytrhopoietin can also be used in treatment following an acute stroke. Initial results indicate that EPO significantly reduces the risk of neurological deficits.
