Endovascular Treatment in Peripheral Artery Diseases

When it comes to peripheral artery diseases, diseases related to the entire arterial system other than the coronary vessels in the heart come to mind. Vascular occlusion and stenosis occur particularly due to the fat accumulation and cholesterol residues, and calcification in inner walls of the leg arteries over time.

The surgical method has ceased to be the only solution with the support of the developing technologies in recent years. A planned medical intervention for correctly selected patients ensures at least as good results as a surgical success. Thanks to his experiences in the field, Assoc. Prof. Dr. İlker Kiriş provides effective services in designating the appropriate treatment plan to increase patients' quality of life.

Diagnosis and Treatment Process in Peripheral Vascular Diseases

Peripheral artery diseases, which develop slowly but cause various problems throughout the process, affect different body parts. Among the blood vessels most affected by this situation are the carotid artery, kidney, intestines, and arteries extending to the legs.

The late 50s are the period with the highest incidence of peripheral artery diseases, which are directly associated with age. If the problem is in the leg veins, the symptoms are the pain that ends when resting and increases when forced. It is also normal for the pain to spread to the thigh and hip area at some periods. Feeling cold on the feet can also be considered among the most common symptoms of this disease.

Risk Groups in Peripheral Artery Diseases

The most important habit that increases the risk of developing this disease is smoking. High cholesterol, diabetes, and hypertension can also be listed as critical causes. Although rare, rheumatic problems, obesity, and alcohol addiction also contribute to vascular disease incidence. With the researches carried out in our clinic, the disease is correctly diagnosed.

For correct planning before the treatment, the following are examined for the patient;

• Familial cardiovascular health,
• Existing chest pains,
• Presence of non-healing wounds on the foot,
• Dizziness,
• A history of weight loss,
• Temporary or permanent paralysis condition.

Physical Examination for Pre-Diagnosis

Firstly, a face to face conversation is carried out with the patients who visit our clinic from İzmir and its surroundings in a polyclinic environment about their complaints and symptoms. The patient is asked questions about his/her medical history. Then the arterial pulses in the legs are examined manually. Whether there is a murmur or not is found out by checking the carotid artery with a stethoscope. After these examinations, arterial ultrasonography is conducted if necessary.

Advanced diagnostic methods are applied when detecting differences in the skin color and temperature, wounds, thinning of the hair on the legs, and visible changes on the skin. Besides, the patient's blood pressure may be required to be monitored regularly for a certain period. A conclusion is made after assessing the findings obtained at the stage of diagnosis, the patient's history, a physical examination, laboratory analysis, ultrasonographic images, MRI, angiography, and computed tomographic angiography information as a whole.

Treatment Methods in Peripheral Artery Diseases

Considering the developments in the field of medicine, our services are focused on maximizing the quality of life of patients.

Treatment plans in which current knowledge and experiences are interpreted under the patient's conditions are drawn up as follows;

1. Medical treatment
2. Endovascular treatment
3. Surgical treatment

• 
  Purpose of medical treatment; the first goal at this stage is to improve the existing symptoms. The recommended drug therapy is strengthened through exercises. A daily and weekly plan boosts the patient's quality of life and comfort. During this process, additional suggestions are made for smoking patients to give up this habit. Drug treatment is prepared under the patient's condition, and it is checked at regular intervals.
  
  
• Purpose of endovascular therapy; This process achieves a high level of success is primarily and aims to heal the patient without any need for surgical intervention. This treatment, which does not involve any risk, has a high success rate.
  
  
• Purpose of surgical treatment; The aim is to solve the problems by considering the commonly used methods. At this stage, the best decision is made with the patient himself and his family by taking the patient's other health problems, problems with the peripheral artery, and the degree of the disease into account. Surgical treatment has a high success rate.

Balloon and Stent Therapy in Peripheral Artery Diseases

Interventional treatments for leg artery occlusion previously consisted entirely of surgical operations. However, over time, intravenous (endovascular) treatments have come to the fore. Endovascular treatments are performed only by numbing the groin area without requiring patients to undergo general or spinal anesthesia. These treatments are usually performed in the inguinal artery through the needle hole, without making large skin incisions in artery operations. Endovascular treatments are performed in an angiography unit. The treatment is based on passing through severe stenosis or obstructions in the leg arteries with a suitable wire and then expanding that area by inflating a balloon. When necessary, stents of appropriate diameter can be placed in the relevant regions in the form of a metal cage, expanded within the vessel, and maintaining that shape.