Arteries play a vital role in the human body. The arteries are blood vessels that carry oxygen-rich blood from the heart to the tissues and other organs of the body.

What is Arterial Blockage?

Healthy arteries allow blood to flow smoothly all over the body, but when cholesterol, fat, or calcium, which is called plaque build-ups in the artery’s inner walls, it slowdowns the blood flow and in some instances it blocks it altogether.

Clogged or blocked arteries highly increases the risk of heart attack or stroke. Similarly, in the limbs, it increases the risk of limb ischemia (reduced blood supply to the limbs) resulting in pain / non healing ulcers / limb loss.

The build-up of plaque in the arteries is a disease called  Atherosclerosis.  The overtime build-up of plaque (fat, cholesterol, and other substances) makes the inner walls of arteries narrow, and it becomes harder for blood to flow smoothly.

When the arteries become incredibly narrow, it blocks the path and prevents the blood flow towards arms, stomach, kidney, and most commonly towards the legs.

Atherosclerosis is one of the most common causes of Peripheral Artery Disease (PAD) and Carotid Artery Disease.

Peripheral Artery Disease (PAD)

Peripheral Artery Disease is quite a common disease. The disease affects the body’s main blood vessel aorta or the iliac arteries (the branches of the aorta artery) that carries blood to the pelvic organs and legs. It can also affect blood vessels beyond the pelvis or those in the upper limbs.

PAD is a silent disease because it doesn’t show any early signs & symptoms.

When the amount of plaque in the inner arteries builds up, it develops some signs & symptoms.

 The symptoms may include-  pain in the leg and thighs, cold feet, cramping in the buttocks, may develop foot ulcers or gangrene.

The initial symptom is claudication. This means that after walking for a specific distance, the patient starts experiencing severe calf/thigh/buttock pain which gets relieved within few minutes of stopping.

The next symptom is rest pain. This occurs in night when the patient tries to sleep. Even analgesics or pain killers may not be effective. Often, we have so many patients who have not slept properly even upto a month coming to our OPD.

Next stage is of tissue loss – non healing ulcers and gangrene.

Carotid Artery Disease (CAD)

There are two carotid arteries that are present in the human body. One is the external carotid artery, and the other is the internal carotid artery.

The external carotid artery supplies blood to the neck, face, and scalp.

The internal carotid artery carries blood to the brain.

 The two carotid arteries are located on both sides of the neck.

When the carotid arteries become narrow due to the accumulation of plaque, it increases the risk of stroke.

The symptoms of CAD may include- numbness in the limbs and face, weakness or paralysis, dizziness, difficulty in speaking trouble in seeing, and severe headache.

Symptoms of Arterial Blockage

The symptoms of arterial blockage may vary. It depends upon the affected artery.

Symptoms of Peripheral Artery Disease (PAD)

The peripheral artery serves the arms, legs, stomach, and head. PAD mostly affects the main arteries (aorta and iliac artery) in the legs. 

The symptoms of PAD include-

  • Pain and weakness in the legs
  • Hairs loss on the legs
  • Pain in the leg and thigh while walking or climbing stairs
  • Coldness in the lower leg or feet
  • Pain in the hips or calves region
  • Numbness in the leg
  • Sores or foot ulcers develop on the feet or leg that are difficult to heal
  • The skin on the legs may turn bluish or pale
  • The shiny texture of the skin on your legs
  • Pain in the leg while resting
  • Untreated or long term Peripheral Artery Disease can develop gangrene or lead to amputation.
  • Brittles toenails
  • Slower growth of toenails

Risk factor for Peripheral Artery Disease

  • Family history
  • Diet
  • Smoking
  • Diabetes
  • Obesity
  • High cholesterol
  • Age

Symptoms of Carotid Artery Disease (CAD)

The carotid artery serves the upper portion, from the neck to the brain. CAD increases the risk of stroke or TIA (ministroke)

The symptoms include-

  • Sudden numbness in the face, legs, and limbs
  • Weakness  in the face, legs, and limbs
  • Trouble in speaking and understanding
  • Difficulty in seeing
  • Dizziness
  • Vision problem
  • Sudden severe headache

Risk factor for Carotid Artery Disease

  • High blood pressure
  • Diabetes
  • Use of tobacco
  • Obesity
  • High cholesterol and blood-fat
  • Family history
  • Lack of exercise

Causes of Arterial Blockage

The arterial blockage begins with the damage of the inner walls of the artery.

When the high cholesterol, smoking, hypertension, excess body fat, calcium, and other substances called plaque deposits in the artery’s inner wall, it makes the inner walls narrow and narrow walls limits or entirely restricts the blood flow.  These plaques may burst and can cause blood clots which can go downstream and can cause sudden occlusion of the existing blood supply and also of bypass channels which may have formed due to long standing disease.  

Treatment of Arterial Blockage

Numerous treatment options and preventions are there to treat arterial blockage.

The treatment options are-

Medications

First, doctors may prescribe some medicines to control the build-up of arterial plaque. Some particular drugs are effective in controlling and restricting the accumulation of plaque in the artery walls. They are-

  • Aspirin
  • Blood-pressure lowering drugs
  • Cholesterol-lowering drugs such as statins
  • Any blood-thinning medicine

Interventional procedures/ Non-surgical methods

Some arterial blockages are cured with non-surgical procedures.

  • Balloon Angioplasty

In this procedure, a specially designed catheter is inserted in the clogged artery.

The catheter is used to push the plaque aside and stretch the obstructed arteries to improve the blood flow in the arteries.

The procedure is also known as angioplasty.

The Angioplasty procedure doesn’t require any deep incisions. It hardly takes 30 minutes to 2 hours, and you will be discharged on the same / next day. Only local anaesthesia is enough.

  • Thrombolytic therapy

In this therapy, doctors will use some clot-dissolving drugs to liquefy the blood clots.

The clot-dissolving drug is given directly in the artery via injection. This is essentially used in those patients in whom, a clot has broken off from somewhere and had got lodged in blood flow beyond the diseased segment. Also it is imperitive that patient comes to a vascular surgeon as soon as possible because, the longer he takes to come to a treatment facility, lesser are the chances that the clot is still soft for the drug to act.

  • Stent placement

In this procedure, a tiny metal tube called a stent will be placed in an artery to keep it open and to restore adequate blood flow.

Medicine coated stent is also used to insert in the blocked artery for a temporary solution.

The procedure will take only 30-60 minutes, and the patient will be discharged on the same day.

Surgery

In some cases of arterial blockages, surgery is required to treat the clogged arteries.

  • Bypass surgery

In Bypass surgery, the main motive is to create a new pathway for proper blood flow by using a new blood vessel from other parts of the body or by a human-made vessel.

In this surgery, the surgeon makes an incision near the blocked artery and attaches the graft (new blood vessel) or human-made vessel above and below the blockage to bypass the clogged artery.

The graft or new vessel allows the oxygen-rich blood to flow correctly to the leg.

Preventions

Some efforts may help to stop the progression of the arterial blockage and improve the condition.

  • Change lifestyle
  • Quit smoking
  • Avoid alcohol
  • Maintain healthy cholesterol
  • Eat a healthy diet
  • Maintain weight
  • Exercise daily
  • Control your sugar level
  • Maintain your blood pressure