Peripheral therapeutic catheterization is used in cases of arterial blockages in the legs caused by arterial sclerosis and reduced blood flow to the extremities, which can lead to difficulty in wound healing, ulcers, tissue loss, and even tissue death, as seen in advanced stages of gangrene.
Peripheral arterial occlusion, or peripheral artery disease (PAD), is a common manifestation of atherosclerosis that leads to impaired blood circulation in the lower extremities. The global prevalence of PAD is estimated to be over 200 million individuals, and this number has increased by more than 20% over the past decade.
If left untreated, occluded arteries that are supposed to supply the body with blood and oxygen can lead to serious health problems due to the accumulation of excess fats and cholesterol. Several factors contribute to fat accumulation, including:
Complications of vascular occlusion often occur due to reduced or absent blood flow, and may include:
Before performing peripheral artery disease, proper diagnosis of peripheral artery disease is required. This can be done using one or more of the following diagnostic methods:
– Ankle-brachial index (ABI): The ankle-brachial index is a non-invasive test to measure blood flow in the arteries of the legs and arms. ABI is calculated by dividing the blood pressure in the ankle by the blood pressure in the arm. If the resulting ratio is less than 0.9, it may indicate the presence of peripheral artery disease in the patient’s legs.
– Doppler ultrasound: Doppler ultrasound is a non-invasive procedure where high-frequency sound waves are used to assess the functions and structures of blood vessels without the use of any injections or radiation.
– Magnetic resonance angiography: Magnetic resonance angiography is a type of magnetic resonance imaging that specifically visualizes blood vessels in the body.
1- Peripheral therapeutic catheterization is performed under local anesthesia, involving a small puncture in an artery in the thigh typically.
2- A catheter tube is inserted into the puncture hole to the affected area, guided by X-rays. The catheter is connected to a camera to visualize the arteries. The catheter is essentially a narrow plastic tube with a balloon at its tip, which is inflated to expand the artery and keep it open.
3- Sometimes a metal stent, which is cylindrical and mesh-like and expandable, is inserted using the catheter to keep the affected artery open to its normal size, ensuring blood flow to the extremities. Dr. Hossam El Mahdy decides to place the stent when the catheter alone cannot adequately expand the artery or in specific locations.
4- After the procedure, which typically takes no more than 30 minutes, the tube is removed, and the patient usually feels no pain. The doctor applies pressure to the entry site in the thigh for about 10 minutes to prevent arterial bleeding.
5- The patient is then advised to wear compression stockings and reduce movement temporarily to prevent hematoma formation.
With this advanced technology, many patients suffering from peripheral artery disease can now be treated with less invasiveness and risk compared to previous surgical procedures, achieving similar results and shorter recovery times.
Peripheral vascular diseases can be prevented by preventing atherosclerosis and controlling risk factors. A prevention program may include:
– Quitting smoking and avoiding secondhand smoke and tobacco products in general.
– Making dietary changes by reducing fats, cholesterol, and carbohydrates while increasing the intake of fruits, vegetables, low-fat dairy products, and lean meats.
– Treating high cholesterol levels with medications prescribed by the treating physician.
– Losing excess weight.
– Taking medications to reduce the risk of blood clots, as determined by the treating physician.
– Exercising for 30 minutes or more daily.
– Managing diabetes.
– Controlling high blood pressure.
