The obstructive arterial disease of the legs is the condition in which the oxygenated blood supply for legs and feet is compromised. In the first phases of the disease, patients feel leg pain when walking. After a certain time, when the arteries are more compromised, tissues start to die, making necessary the amputation of the affected limb. This disease can also start suddenly, due to an acute obstruction of the artery.

There are several risk factors for the arterial disease, like genetics, arterial hypertension, Diabetes mellitus, smoking, abnormal levels of cholesterol, obesity and sedentarism or lack of exercise.

The arterial disease begins with the formation of plaques in the inner wall of arteries. Those plaques progresses and gradually block the arterial blood flow. At the beginning, those obstructions are imperceptible, but afterwards due to the fact that this disease is progressive, patients start feeling calf pain when they walk long distances. This symptom is called intermittent claudication. As arteries get narrower, patients feel pain walking shorter distances. Finally, the pain is constant, even without any walking, involving feet, and wounds due to cellular death appear. Normally, at this point, amputation of the affected limb is indicated.
In some cases, the arterial occlusion is acute, due to a clot blocking the blood flow. Those patients need to be treated quickly, even with angioplasty and stent implantation or with a substance to dissolve the clot.

The interview with your doctor at the time the leg pain starts is very important. He will indicate you an arterial Doppler to evaluate the blood flow in your leg arteries and will probably prescribe you some medication to improve the circulation and slow the progression of disease. Patients with Diabetes mellitus have to be evaluated periodically, even without symptoms, because they are very prone to have "silent" vascular diseases.

If the obstruction of the arteries is severe, you will probably need a digital arteriography. This will allow your doctor to visualize the arterial vessels and to measure the obstructions in order to plan the best strategy to obtain a satisfactory solution. Digital arteriography is a safe technique and consists in a puncture, under local anesthesia, in the femoral artery, at the groin level. After that we pass a catheter and inject contrast in the arteries to see the inner side of them. The procedure takes about twenty minutes, with the patient awake, it is not painful and has very low chances of complications.

Angiography that shows significant stenosis at the Aortic Bifurcation