How to treat lower extremity arterial occlusion?

Up to now, arterial occlusion is relatively common. Many patients will develop complications due to the disease. Usually, arterial wall blockage will occur in the lower limbs. Some patients usually have bilateral lower limbs, usually accompanied by pain and walking disorders, intermittent claudication, and often symptoms of fear of cold and heat, and even severe congestion. Most patients will have complications, unbearable pain, and suffer from the disease. The pain of lower limb artery occlusion is extremely great. We need to have a detailed understanding of this disease.

Non-surgical folding treatment

It includes controlling diet, exercising properly, avoiding smoking, keeping warm; using lipid-lowering drugs, vasodilators and traditional Chinese medicine; limb negative pressure therapy, etc. The above treatments can also be used before and after surgery.

Folding surgery

Depending on the location, extent, range and collateral circulation of the lesion, the following surgical methods can be used:

1. Arterial bypass surgery

Use artificial blood vessels or autologous veins to perform bridge-type end-to-side anastomosis at the proximal and distal ends of the occluded artery to restore blood flow. It can be divided into anatomical bypass (located near the lesion) and non-anatomical bypass (far away from the lesion). The former is commonly used, while the latter is only used in cases of local infection or when laparotomy or thoracotomy is difficult to tolerate.

2. Endarterectomy

It is suitable for arteries with a short lesion range, medium or larger, and patent distal ends.

3. Omentum transplantation.

4. Venous arterialization surgery

It is suitable for patients with extensive limb artery occlusion and normal veins. It is mostly used in lower limbs. There are three types of surgery: 1. Superficial vein type. Use the inverted great saphenous vein on the healthy or affected side, anastomose the proximal end with the femoral artery or popliteal artery, and anastomose the distal end with the distal segment of the great saphenous vein at the ankle plane to establish a channel for the great saphenous vein to perfuse blood to the distal end. ②High deep vein type. Use artificial blood vessels or autologous great saphenous vein to bridge the proximal end of the occluded artery and the superficial femoral vein. After 3 to 5 months, the superficial femoral vein proximal to the anastomosis is ligated again to make it a one-way perfusion. ③Low deep vein type. First, a bypass is performed between the occluded proximal artery and the tibiofibular vein or the posterior tibial vein, and a second operation is performed several months later to ligate the proximal vein of the anastomosis.