If it's too light, it's "leg-breaking", but if it's too heavy, it's "life-threatening"! Here's what you should know about "leg-breaking"

Recently, the weather has turned cold. Taxi driver Mr. Liu always felt that his legs were not strong enough, his calves were cold, sore, swollen and weak, and even painful. He thought it was his "old cold legs" that had flared up.

Upon recommendation, he immediately went to the outpatient clinic of Li Wenquan, director of the Intervention Department of Hunan Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine) , and was diagnosed with "leg infarction", namely lower limb arteriosclerosis obliterans (ASO). After the occluded blood vessels were opened through minimally invasive intervention, his symptoms were immediately relieved and he was able to move freely the next day.

We have heard a lot about myocardial infarction and cerebral infarction, but this is the first time that Master Liu has heard of "leg infarction". Today, let us follow Director Li Wenquan to learn more about this disease, lower extremity arteriosclerosis obliterans (ASO).

1. What is lower limb arteriosclerosis obliterans?

Lower limb arteriosclerosis obliterans is a common peripheral vascular disease. The disease is caused by hardening, stenosis or occlusion of the lower limb arteries, resulting in insufficient blood supply to the lower limbs, thus causing a series of symptoms.

2. What are the symptoms of lower limb arteriosclerosis obliterans?

Early stage: The legs and feet become cold and numb, and feel uncomfortable. The lower limbs hurt when walking, and it is relieved after rest, which is the so-called "intermittent claudication".

Middle stage: Even without exercise, the lower limbs continue to hurt, which worsens at night, the so-called "rest pain".

Late stage: ulcers and gangrene appear on the lower limbs, cyanosis appears on the soles of the feet, and the pain is severe and unbearable.

3. How to discover "leg stick"?

Three-step method - teach you to find "leg jam" at home, namely "one look, two touch, three walk".

First look: Check the color of the feet to see if they have turned white or dark purple.

Second touch: Feel the temperature changes of both feet and compare them to see if the dorsalis pedis artery becomes weaker or disappears.

Three walks: Walk for a distance at a normal speed and feel whether your calves or lower limbs feel weak, sore, or other discomfort.

4. What are the causes of lower limb arteriosclerosis obliterans?

The risk factors include: high blood pressure, high blood lipids, high blood sugar, high uric acid, advanced age, high smoking addiction, high weight, high mental stress and lack of exercise.

5. How to diagnose lower limb arteriosclerosis obliterans?

1. Medical history inquiry: The doctor will ask in detail about the patient's leg pain symptoms, onset time, aggravating and relieving factors, previous medical history, surgical history, trauma history, etc.

2. Physical examination: Ankle-brachial index (ABI) is the most basic non-invasive vascular examination method, which has the advantages of being economical, rapid, and simple. ABI < 0.9 indicates lower limb vascular abnormalities.

3. Imaging examination: Ultrasound examination is the preferred screening and follow-up method. In addition, CTA/MRA examination is very important, which can directly reflect the stenosis/occlusion site, collateral circulation, and fully provide information about the arteries of the affected limb, which is helpful for the formulation of treatment plans.

6. How to identify “leg stem”?

Because the symptoms of lower limb arteriosclerosis obliterans are not typical, it is easily confused with old cold legs and lumbar disc herniation.

1. Old cold legs

Commonly known as "old cold legs", knee osteoarthritis is a chronic disease that may be asymptomatic in the early stages, but gradually develops pain and stiffness, often accompanied by changes in posture in daily life. The main symptoms are knee soreness, knee swelling, knee popping, etc.

2. Lumbar disc herniation

Lumbar disc herniation and lumbar spinal stenosis can also cause lower limb pain, intermittent claudication and other symptoms. But generally speaking, lumbar spondylosis may cause pain at rest or when walking, and the lower limbs may have segmental sensory disturbances. Generally, the dorsalis pedis artery pulsation is good; the claudication caused by lower limb artery ischemia is painful only after walking for a while, and the dorsalis pedis artery pulsation is weakened or disappeared in vascular intermittent claudication.

If you have the above symptoms, it is recommended to go to a regular hospital for comprehensive examination and active treatment.

7. How to treat lower limb arteriosclerosis obliterans?

1. Traditional Chinese Medicine Treatment

Based on the principle of syndrome differentiation and treatment, Chinese medicine is taken internally and supplemented with external treatment such as Chinese medicine fumigation, acupuncture, cupping, scraping, acupoint injection, etc.

2. Western medicine treatment

(1) Drug treatment: Actively use antiplatelet drugs, anticoagulants, lipid-lowering drugs, and vasodilators to treat the patient's underlying diseases, such as hypertension, diabetes, etc.

(2) Surgical treatment: including surgical thrombectomy, vascular bypass and endarterectomy. However, most patients with lower limb arteriosclerosis obliterans are elderly patients and often have other underlying diseases. They are unable to tolerate the greater surgical trauma.

(3) Interventional treatment: Compared with surgical treatment, it has the advantages of less trauma, strong repeatability, rapid postoperative recovery, and fewer complications. Therefore, it has gradually become the main means of treating lower limb arterial occlusive disease.

Experts advise

Li Wenquan, director of the Interventional Department, reminds us that lower extremity arterial occlusive disease is a hidden disease that is easily overlooked. If not discovered and treated in time, it may lead to forced amputation due to limb necrosis, and in severe cases it may even be life-threatening. Once abnormal symptoms occur, you should seek medical attention in time to identify the cause and take effective treatment measures. Let us pay attention to our health together and stay away from the trouble of "leg occlusion".

Hunan Medical Chat Special Author: Hai Juexing, Department of Interventional Medicine, Hunan Hospital of Integrated Traditional Chinese and Western Medicine (Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine)

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(Edited by YT)