Intermittent claudication is arteriosclerosis in the vessels of the leg. The technical term is peripheral arterial occlusive disease (pAVD). A typical symptom of this narrowing of the arteries is severe pain in the legs. This primarily manifests itself during physical exertion, which means that those affected often have to take breaks when walking. Many try to make the frequent standing look like window shopping by always stopping in front of stores. If diagnosed early, the condition can be treated well. If it is diagnosed late, surgery is often the only option.
Narrowed arteries as the cause
Shop-window disease is a form of peripheral arterial occlusive disease (pAVD) in which the arteries are narrowed by deposits in the walls of the blood vessels (arteriosclerosis). This restricts blood flow, which initially causes no symptoms at rest. It is only when the oxygen demand of the muscles increases during physical exertion, for example when walking or running, that the blood flow is no longer sufficient and the muscles receive too little oxygen. This manifests itself as severe pain, which only disappears when physical exertion is interrupted. Arteriosclerosis occurs when fat is deposited in the walls of the blood vessels. This is favored above all by too high blood fat values, which can be caused by wrong nutrition and lack of exercise or by genetic defects. Likewise, smoking, high blood pressure (hypertension), diabetes mellitus and obesity increase the risk of vasoconstriction.
Symptoms of shop window disease
The narrowing of blood vessels is a gradual process that often goes unnoticed for a long time. The course of pAVD is divided into four stages according to Fontaine’s classification:
- In stage 1, no symptoms are present (asymptomatic pAVK).
- Only when the vessel diameter is already significantly reduced, symptoms appear. The complaints show at the beginning only with stronger load – for example, when climbing stairs (stage 2).
- Later, the pain is already noticeable with increasingly shorter walking distances. Other symptoms of shop window disease can be a pale skin color and coldness of the skin on the lower legs.
- In the advanced stage (stage 3), the legs hurt even at rest.
- Due to reduced blood flow, wounds on the feet heal worse, in the worst case tissue may die (stage 4). If this is the case, the tissue must be removed, otherwise a life-threatening blood poisoning threatens.
Early detection and diagnosis of pAVK
Often, the onset of occlusion of the arteries is detected by chance during a routine examination. If the physician cannot palpate the pulse at the ankles and feet, this may be an indication of early-stage pAVD if risk factors are present. If there is a suspicion of pAVD, the doctor takes the so-called ankle-brachial index: if the blood pressure at the ankle is greatly reduced in relation to the blood pressure at the arm, this is a sign that the leg vessels are narrowed. This can also be the case if the shopfitting disease has not yet manifested itself with its typical symptoms. To confirm the diagnosis, the blood flow in the arteries can be visualized with a special ultrasound device. In this way, it can be determined where and how severe the narrowing is.
Therapy for shop window disease
If windowpane disease is still in its early stages, reducing risk factors is often enough to halt the progression of the disease: Abstaining from nicotine and normalizing weight, blood pressure, and blood lipid levels prevents atherosclerosis from progressing further. A special exercise program supports the therapy: the targeted activation of certain muscle groups promotes blood flow so that new vessels can form around a constriction. In addition, the doctor can prescribe drugs that disrupt the function of the blood platelets. These platelet aggregation inhibitors prevent blood clots from forming at the narrowing sites.
Treatment of late-stage pAVD
In the late stages of windowpane disease, such treatment is usually no longer possible, so surgery is often necessary. This involves inserting a catheter into the leg artery and dilating the vessel with a small balloon.A vascular support (stent) is then inserted to restore blood flow. If the constriction is very long, a bypass may have to be inserted: This involves building a bypass from another vessel to bridge the blocked area. If the pAVK is not treated, in the final stage there is a risk of leg amputation due to the lack of blood supply to the tissue. If narrowing of the leg arteries is detected, it is highly likely that other vessels in the body are also affected. Thus, shop window disease indirectly indicates an increased risk of heart attack and stroke. This is another reason why it is important to adjust lifestyle habits and minimize risk factors.
Preventing windowpane disease
To protect the vessels from calcification, abstaining from nicotine is a crucial step. In addition, a healthy diet with sufficient unsaturated fatty acids helps normalize blood lipid levels and reduce excess weight. If you have conditions such as diabetes or high blood pressure, it is important that these are treated appropriately. This is because having well-controlled blood sugar levels and lowering high blood pressure also reduces the risk of atherosclerosis.