Occlusive arterial disease occurs when arteries narrow due to plaque buildup, restricting blood flow to vital organs or limbs. This can lead to pain, numbness, and coldness in affected areas, with more serious complications like heart attack, stroke, or tissue death in advanced cases. Smoking, high blood pressure, high cholesterol, diabetes, obesity, and a sedentary lifestyle increase the risk of developing OAD. Treatment typically involves lifestyle changes, medications (like blood thinners and statins), and procedures like angioplasty, atherectomy, or bypass surgery to restore blood flow. Early detection and managing risk factors are critical to preventing severe complications.
Occlusive arterial disease is characterized by inadequate blood flow to various parts of the body, due to narrowing of arteries. The arteries can become narrower because of fatty plaque deposits which buildup on their inner walls. The plaque hardens the walls of the arteries and starts to clog them. This reduces the amount of blood that can flow through the arteries, as the cross-section gets smaller. Occlusive arterial disease can have varying symptoms, depending on which artery is affected. However, general symptoms include pain, pale skin, numbness, coldness in the extremities and a weakened pulse. Smoking, high blood pressure, high cholesterol, mismanaged diabetes, obesity and a sedentary lifestyle increase your risk of developing an occlusive arterial disease. Occlusive arterial disease is an umbrella term that covers multiple variants of the disease. They are classified according to the arteries affected, and the body part the affected artery supplies blood to.
Peripheral Occlusive Arterial Disease (POAD) is the most common type of occlusive arterial disease. It affects the blood supply to the limbs, particularly the legs. When the arteries supplying blood to the legs and feet become narrower, patients may experience symptoms such as numbness or tingling in the feet, leg cramps, pain and rapid fatigue while exercising. The patient’s leg or arm may also turn bluish in color and turn cyanotic due to oxygen deprivation. The pulse may become weak in the limb, causing a loss of sensation and even paralysis. The symptoms can develop gradually or all of a sudden. Sometimes, patients experience symptoms only during activity and observe that the symptoms subside with rest. This is referred to as intermittent claudification. When POAD gets severe, it could result in critical limb ischemia. This is when blood flow becomes so restricted that it causes severe pain even when the limb is at rest, non-healing wounds and gangrene (tissue death).
Peripheral occlusive arterial disease is diagnosed based on the patient’s symptoms and a physical examination of the limb. The doctor will examine the skin color and temperature of the affected arm or leg. They will also perform tests to check how well blood is able to flow through the affected limb. Blood pressure measurement is done using a stethoscope and a blood pressure cuff. The difference in blood pressure between the arms and the legs is noted, and this measurement is used to diagnose peripheral occlusive arterial disease. The cardiologist will also measure the pulse and the transcutaneous oxygen through the affected arm. A Doppler ultrasonography can be used to confirm the diagnosis by directly measuring blood flow during rest or exercise.
Cerebrovascular occlusive disease, also known as carotid atherosclerosis, is the result of fatty deposits and plaque buildup in the carotid or vertebral arteries that supply blood to the brain. This condition restricts oxygen supply to the brain and can result in a stroke. Patients may experience symptoms like sudden numbness or weakness, typically in one side of the body. They may also have trouble speaking, lose balance or have severe headaches. Symptoms usually do not appear until the condition is serious enough to deprive the brain of oxygen. Patients with high blood pressure, diabetes, high cholesterol levels, a lethargic lifestyle or obesity are at a higher risk of cerebrovascular occlusive disease. Having a family history of cerebrovascular occlusive disease also increases your risk of developing the condition.
Diagnosis of cerebrovascular occlusive disease is done based on patient medical history, a physical exam and a panel of tests. Most patients are diagnosed only once they’ve had a stroke, as there are no warning symptoms. After a stroke, the doctor will check for blockages in the arteries, and this often leads to a diagnosis. During the physical exam, the doctor will listen to arteries in the neck using a stethoscope for an abnormal whistling sound. This is called a murmur or a bruit and is an indication that the artery is blocked. The doctor will then perform an ultrasound or a CT scan to locate the blockage. A minimally invasive diagnostic test called a cerebral angiography may also be performed to get a closer look at the blockage and confirm the diagnosis.
A chronic coronary total occlusion is a medical condition in which the arteries that supply blood to the heart muscle become partially or totally blocked. The obstruction is usually caused by plague, made of cholesterol and other waste in the blood. When the heart muscle is deprived of blood due to the obstruction, it doesn’t get enough oxygen and stops functioning. The heart muscle dies – This is a heart attack. Chronic coronary total occlusion is a serious condition and is a major cause of death in India. Patients with this condition experience chest pains or tightness, shortness of breath, fatigue, dizziness, irregular heartbeats and nausea. Symptoms usually appear during periods of activity or exertion. As with most other occlusive arterial diseases, the risk of chronic coronary total occlusion increases if the patient smokes or has high cholesterol, hypertension or diabetes.
Chronic coronary total occlusion is diagnosed based on patient medical history, a physical exam and a coronary angiogram. The coronary angiogram is a minimally invasive procedure in which a contrast dye is injected into the coronary artery and then viewed through an X-ray. This is done to get accurate images of the coronary artery and the blood flowing (or not flowing) through it. The doctor may also perform an EKG, and echocardiogram, a stress test and a cardiac MRI to fully assess the functioning of the patient’s heart.
Narrowing of the arteries that carry blood to the kidneys (called renal artery) is called renal artery stenosis. This condition prevents oxygen-rich blood from reaching the kidneys. Reduced blood flow to the kidneys can damage kidney tissue and reduce its ability to filter wastes and remove excess fluid. Renal artery stenosis can increase blood pressure throughout the body and cause kidney failure. Unfortunately, the disease doesn’t cause any specific symptoms. The first sign of renal artery stenosis is usually elevated blood pressure that is hard to control. Pre-existing conditions such as hypertension, diabetes, high cholesterol or chronic kidney disease increase your risk of developing renal artery stenosis.
If your blood pressure is elevated, the doctor may proceed to check kidney function. This is accomplished through collecting data from a panel of blood tests and urine tests, as well as various imaging tests. The most common imaging tests performed are an abdominal ultrasound, a doppler ultrasound, and a CT angiogram. The cardiologist may also choose to perform a magnetic resonance arteriogram to produce a 3D image of the kidney and the associated blood supply network.
The main goals of treatment for all occlusive arterial diseases are:
Treating occlusive arterial diseases often requires a multi-prong approach. The treatment program involves a combination of medication, lifestyle changes, surgical or minimally invasive procedures and strategies for risk factor management:
Medication – Patients are usually given medication to reduce blood pressure, in the form of beta-blockers or calcium channel blockers. They may also be prescribed angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) to prevent blood vessels from narrowing. Blood thinners and high cholesterol medication are also commonly prescribed to patients with occlusive arterial disease.
Angioplasty – Angioplasty is a minimally invasive procedure performed to improve blood flow. It is commonly performed to treat patients with coronary artery disease, usually as an emergency measure after a heart attack. During the procedure, a catheter is inserted into a blood vessel and guided to the arterial blockage. Once in place, a balloon at the tip of the catheter is inflated at the narrowed spot, stretching the artery back to its original cross section. A tiny metal mesh coil known as a stent is placed here to keep the artery walls in this position, and then the balloon is deflated and removed. The entire procedure is performed under X-ray fluoroscopy visualization.
Atherectomy – An Atherectomy is a minimally invasive procedure to remove plaque build-up from the inside of artery walls. Think of it like de-silting a riverbed. The plaque is shaved off using tiny rotating blades or vaporized using a laser. This is a minimally invasive procedure, so it is performed using a catheter inserted through a key-hole incision, under X-ray fluoroscopy guidance. Atherectomies are commonly used to treat coronary artery disease or peripheral occlusive arterial disease. Atherectomies are often performed when angioplasty results have not held long-term, or if the plaque clogging the artery has hardened too much.
Bypass surgery – Bypass surgery is recommended to patients who have severely clogged arteries. The procedure takes a re-routing approach, rather than a widening approach, to the problem. During the procedure, the affected section of the artery is “by-passed” by creating an alternate path using a healthy blood vessel. This restores blood flow to the affected body part. This is an open surgical procedure, performed under general anaesthesia. The surgeon may choose to create a man-made graft or harvest a healthy blood vessel from elsewhere in the body to create the by-pass.
Endarterectomy – This is a surgical procedure to removal plaque build-up from a narrowed or clogged artery. Endarterectomy is usually performed to ease blood flow through the carotid arteries, femoral arteries (in the legs) or the aorta. The procedure is performed through an incision directly above the obstruction in the artery. A shunt is placed to ensure uninterrupted blood circulation. Then, the plaque is removed mechanically, using an endarterectomy spatula tool. After all the plaque is removed, the artery is reconstructed using a patch and the entire incision is closed. Patients with excessive calcification (hardened plaque), severe emphysema, radiation damage to the area or infection are not good candidates for this procedure.
Lifestyle Changes – One of the most impactful things a patient can do to avoid worsening their occlusive arterial disease is quit smoking. Weight management is another key aspect of their lifestyle they need to control. This is done through a balanced, healthy diet and exercise. A heart-healthy diet with lean protein and healthy fats and low sodium helps avoid or delay complications caused by occlusive arterial diseases. Many patients also benefit from supervised exercise classes or personal training. A tailored fitness plan factoring in their baseline health and fitness goals helps them incorporate exercise into their lifestyle in a sustainable manner, without over-exertion or injuries.
Risk Factor Management – For patients with occlusive arterial diseases, managing their risk factors is crucial to reducing strain on the arteries and preventing further blockages. Taking medication and monitoring their blood pressure, diabetes and cholesterol is very important. Making good lifestyle choices goes hand in hand with this.
Treating occlusive arterial disease involves using all these strategies and interventions customized to each patient as per their needs. Early detection and disciplined management are essential to prevent undesirable complications like strokes, heart attacks and limb amputation. By understanding and addressing the underlying factors, patients can improve their quality of life and reduce the impact of this condition.
If you or a loved one are experiencing symptoms of occlusive arterial disease or need expert guidance on vascular health, consult the experienced specialists at Kauvery Hospital. With branches in Chennai, Hosur, Salem, Tirunelveli, and Trichy, Kauvery Hospital offers advanced diagnostics and comprehensive treatment options to help you achieve better vascular health and improved quality of life.
Occlusive arterial disease is a condition where arteries become narrowed due to plaque buildup, reducing blood flow to organs or limbs. It can lead to pain, numbness, and serious complications like heart attack or stroke.
The main types include:
The condition is mainly caused by plaque buildup from high cholesterol, high blood pressure, smoking, diabetes, obesity, and a sedentary lifestyle. Genetics can also play a role.
Symptoms vary by type but commonly include:
Diagnosis may include a physical exam, Doppler ultrasound, CT angiography, coronary angiogram, or MRI. Blood tests and risk factor evaluation are also important.
Treatment depends on severity and may include:
Yes. Quitting smoking, controlling blood pressure, managing diabetes, maintaining a healthy weight, and exercising regularly can reduce risk and slow progression.
Seek medical attention if you experience persistent pain, numbness, cold extremities, chest pain, or high blood pressure that’s difficult to control. Early detection prevents serious complications.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet, Radial Road & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and paediatric trauma care.
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