- Hybrid techniques: stent and by-pass in the same surgical session;.
- • The evaluation of all arteries by a general ultrasound performed by an Angiologist (Prof. Xavier Mouren, M.D.) (Prof. Dr. Xavier Mouren)
Obliterant chronic arteriopathy (OCA) is a common vascular disorder due to different degrees of narrowness (from a simple stenosis to complete obstruction) of the arteries of thelimbs (especially lower limbs). As a matter of fact, the obliterant chronic arteriopathy (OCA) is the result of a much larger disorder, called atheromatosis or atherosclerosis, which consists of the accumulation of fat on the heart, brain, limb arteries etc
The disease may be asymptomatic for a long time or may evolve, being accompanied by minimal symptoms: the symptoms occur when the vascular stenoses become severe or in case of obstruction. Most of the patients complain of a discontinuous pain when walking (claudication), which manifests as muscle cramps at the buttock level, thigh level but especially at the leg level (pulp) and it goes away after resting. In advanced stages, the pain becomes permanent, even when resting, and it does not respond to antialgic medication (against the pain). Unfortunately, the next stage coincides with the alteration of the skin color and it also comes along with the occurrence of the ulcers and gangrene.
Treatament
Adjustment of the risk factors
Medication-assisted treatment: in the less severe cases
Interventional treatment: peripheral arterial angioplasty with or without stent placement and it consists of minimally invasive endovascular desobstruction and dilatation of peripheral arteries. A tube called stent (metal cylinder) is inserted in the location of the stenosis and it is used to keep a proper diameter of the artery.
Surgical treatment-Peripheral arterial bypass. The surgery consists of fitting by-passes which bypass the stenosis or occlusion-affected areas of the peripheral arteries. Venous grafts (pieces of veins-saphenous vein) or Dacron or ePTFE vascular synthetic prostheses are used.
Natural evolution without surgical treatment
Without a adjusting the risk factors, the medical and surgical treatment, the arterial disease progresses towards irreversible ischemia, accompanied by the appearance of gangrene, which leads to the amputation of the affected limb.
The results achieved by surgical intervention
The team of Inimed Clinic, made up of Romanian and French cardiovascular surgeons has a 92% success rate in the surgical and endovascular treatment of the peripheral arterial disease in the past 5 years.
