How is vasculitis diagnosed?

Vasculitis is a common disease in which patients experience numbness and loss of sensation in their legs and feet, and even scalding with hot water may not have much effect. To determine whether a patient has this disease, the diagnosis can be confirmed through photoplethysmography, ultrasound, angiography (DSA), magnetic resonance imaging or CT and other vascular reconstruction examinations.

1. How to diagnose vasculitis

Commonly used clinical examination methods include the following:

(1) Photoplethysmography: It examines the blood supply to the distal arteries of the affected limb and can provide a general understanding of the location and extent of the lesion. It is inexpensive, simple, non-invasive, and can be repeated.

(2) Ultrasound examination: Color duplex B-ultrasound is commonly used, which has similar characteristics to photoplethysmography but has a higher accuracy rate.

(3) DSA examination: It is the gold standard for diagnosing vasculitis. The results of DSA examination are the basis for distinguishing it from other diseases that cause vascular occlusion. However, the examination is expensive and involves certain risks and trauma.

(4) Vascular reconstruction examinations such as MRI or CT: The examination effect is similar to that of DSA, with relatively less trauma and cost.

In addition, most patients are young and middle-aged men, often with a serious history of smoking. When the above tests have positive results and there are clinical manifestations of ischemia, vasculitis can be diagnosed.

2. How to treat vasculitis

1. Quit smoking: The importance of quitting smoking cannot be overemphasized. It is the first and most important step in the treatment of vasculitis. It is also the most important measure to avoid recurrence. It can be said that if you want legs, you don’t have cigarettes, and if you have cigarettes, you don’t have legs. Passive smoking is also harmful and should be avoided as much as possible.

2. Drug treatment: Drug treatment is still the main method for treating vasculitis. Commonly used medicines include two categories: Chinese patent medicines and Western medicines. The more recognized Chinese patent medicines are Danshen and Shengmai Injection. The most reliable Western medicine at present is Kaishi (prostaglandin, a vasodilator). Ambrolizumab and Nobolast are two new drugs that have been recently used in clinical practice and have good effects. Sometimes hormones are needed to control acute seizures.

3. Surgical treatment:

⑴ Arterial reconstruction: Multiple vascular stenoses are a prominent feature of vasculitis, which makes it difficult to solve the problem through surgery. It is impossible to build a bridge between every stenose. A small percentage of patients are able to undergo surgery.

⑵Sypathectomy: This surgery is still an effective method for treating this disease. It can relieve vascular spasm and promote the formation of collateral circulation to a certain extent.

4. Stem cell transplantation treatment: There have been reports of the use of stem cell transplantation to treat vasculitis both at home and abroad. It has certain therapeutic effects in the short term, but the specific mechanism is still unclear and there is a lack of long-term clinical verification.