Arteriopathy: what it is, symptoms, diagnosis and treatment

By Cristiano Antonino On Feb 13, 2023

Arteriopathy is a pathology affecting the cardiovascular system. It is a pathology that develops in the arterial district and consists of the obstruction of peripheral arteries

This causes a reduction in the amount of oxygen that is transported to the tissues.

The main cause of peripheral arteriopathy is advancing age.

In fact, with increasing age, and the concomitant presence of other risk factors, it is more common to incur this condition.

It is estimated that the condition affects one in three 70-year-olds.

The symptoms of arteriopathy can be more or less severe depending on several factors, such as the presence of previous disease or the degree of obstruction of the artery.

This occlusion can affect all body districts.

The narrowing of the artery can cause difficulty in transporting oxygen to the brain and other vital organs, such as the heart and gastrointestinal tract.

It is not easy to reach a diagnosis of arteriopathy, as the symptoms may be confused with those typical of other cardiovascular diseases. For this reason, further investigations may be necessary.

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The symptoms of arteriopathy change depending on several factors, the most important being the level of obstruction of the affected artery

Often, when the condition is not severe, the patient may be asymptomatic or present to the doctor with very nuanced symptoms.

About 20% of those diagnosed with arteriopathy are asymptomatic.

In more complex cases, however, the symptoms can become debilitating and affect the patient’s quality of life.

The classic symptom of this pathology is the perception of a muscular pain, also referred to as ‘claudicatio intermittens’, which generally affects the lower limbs when the subject performs motor activities such as walking.

This pain can be felt in different areas of the body depending on the artery affected by the obstruction.

The problem can present itself with different levels of intensity, from a very mild sensation of discomfort to a more debilitating one of pain or inability to perform certain movements.

In addition to the typical muscle pain of arteriopathy, other symptoms suggestive of the presence of arteriopathy may also occur.

These include:

specific symptoms at the level of the limb affected by the arterial obstruction, such as numbness, change in colour or temperature;
shininess of the skin of the affected limb, with complete loss of hair;
sores;
erectile dysfunction;
erythema of the limbs, specifically redness of the feet.

Causes

Frequently, the cause of arteriopathy is the presence of diffuse atherosclerosis, which leads to changes in the wall of the arteries.

This pathology is caused by the accumulation of substances such as cholesterol, inflammatory cells, fibrotic material and sometimes calcium.

These substances cause an alteration of the blood flow creating an atherosclerotic plaque.

This pathology, over time, leads to the onset of occlusive phenomena.

The risk factors are cardiovascular, atherosclerosis being the main cause of the disease.

These concern, for example, the lifestyle adopted by a person, which can favour the narrowing of the arterial vessel.

In general, other risk factors can be

advanced age
smoking and tobacco
male gender
diabetes
hypertension
alterations in the lipid profile such as high cholesterol or triglyceride levels
homocysteine above the norm
overweight and obesity

Tests and diagnosis

A correct and timely diagnosis of arteriopathy is fundamental for embarking on an appropriate course of treatment, capable of preventing complications and maintaining a healthy cardiovascular system.

The first visit is essential to establish the diagnostic suspicion of arteriopathy

Thanks to the collection of an accurate medical history carried out by the general practitioner, in fact, it is possible to have an overview of the patient’s state of health.

On this occasion, the patient’s perceived symptoms, any cardiovascular problems and pathologies present in the family, and the subject’s lifestyle will be examined in detail.

Following the first examination, the attending physician may request a specialist opinion from the cardiologist.

During the cardiologist’s examination, it will be possible to detect signs of peripheral arteriopathy.

The doctor can observe any differently coloured, reddened or bluish-grey areas of skin when performing the objective test.

Furthermore, through palpation, the cardiologist will be able to judge the characteristics of the peripheral pulses, which are altered in the presence of the pathological condition.

Finally, thanks to auscultation, it will be possible to detect the possible presence of a vascular murmur.

The latter is a symptom of turbulent blood flow, which often occurs as the artery narrows.

Among the tests that can be performed to further investigate and verify the severity of the patient’s condition and make an even more precise diagnosis is the arterial echocolordoppler.

This test uses ultrasound to measure any changes in the acceleration of blood flow.

In fact, if these values exceed a certain threshold, they can be a warning sign of possible arterial narrowing.

Magnetic resonance imaging is also a test that can be requested to assess the anatomy of the artery and the presence of any narrowing. The technical name is Angio-RM (Magnetic Resonance Angiography).

Finally, a test that can be undergone for the diagnosis of arteriopathy is Angio CT (Computised AngioTomography), which, thanks to the injection of a contrast liquid, is useful for assessing the state of health of a given arterial district.

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Arteriography

One test, which can help in making a diagnosis of certainty for arteriopathy, is arteriography.

This rather invasive test makes it possible to visualise the arterial tree of a given district following the injection of a soluble contrast medium.

It is often performed in an outpatient setting or under local anaesthesia.

In order to perform this test, a peripheral artery, usually the femoral, humeral or radial artery depending on the district to be investigated and the operator’s preference, is channeled.

Afterwards, contrast fluid is injected and images are captured in order to obtain data that can be used to confirm the arteriopathy diagnosis.

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The test result is immediate: the contrast acts quickly and the images appear directly on the monitor.

The doctor will then report the test.

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How to prevent arteriopathy?

Prevention plays a fundamental role in this pathology.

Through some simple improvements in one’s lifestyle it is possible, in fact, to prevent many cardiovascular pathologies, including arteriopathy.

These behaviours include:

avoiding smoking,
avoiding a sedentary lifestyle,
practising physical activity, even moderate (a simple brisk walk),
avoiding very fatty foods, preferring a diet rich in vegetables and legumes,
reduce cholesterol through diet,
if you suffer from diabetes, it is essential to manage this condition correctly, controlling blood glucose levels and taking action to lower them,
control blood pressure and manage any hypertension,
avoiding overweight and obesity.

Treatments

Certainly, exercise, diet and abstaining from smoking are behaviours that can prevent the onset of arteriopathy.

If the disease does occur, these measures remain important to prevent the condition from worsening or complications from developing.

In individuals with mild symptoms of arteriopathy, lifestyle changes may be sufficient to prevent aggravation of the condition.

However, in most cases, the disease is diagnosed at an advanced stage and it is necessary to opt for pharmacological treatments to improve the patient’s condition and eliminate symptoms.

These remedies include:

anticoagulants, drugs that reduce blood clotting,
treatments that lower blood pressure, such as ACE inhibitors and sartans,
drugs to reduce cholesterol and triglycerides, such as fermented red rice extract or statins.

In severe cases, drug treatment is not sufficient.

Through surgical operations it is possible to solve the problem, avoiding a worsening that can compromise the subject’s quality of life.

One of the most frequently performed surgeries to resolve this condition is percutaneous peripheral angioplasty (PTA).

This operation is performed under local anaesthesia and using a minimally invasive technique.

Through the use of a catheter, a very thin tube, one enters the artery affected by the obstruction via the wrist, arm or groin.

After entering the artery with this catheter, contrast is injected in order to pinpoint the exact location of the narrowing.

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