The circulation, through a dense network of vessels, ensures that the tissues and organs are supplied with blood and therefore oxygen, which are essential for their survival. The arteries that carry oxygenated blood depart from the heart and which, through ever-smaller ramifications, reach the organs of our bodies, muscles, nerves and skin. Here, through microscopic ramifications, the capillaries, oxygen is transferred to the cells. The blood then, charged with carbon dioxide, returns to the heart through the veins and recharges itself with new oxygen passing through the lung circulation.

Circulation is therefore a continuous system, fundamental for our health and well-being. In some cases, however, something can go wrong, as is the case with peripheral obstructive arterial disease, a condition that – as Dr. Elisa Casabianca, vascular surgeon in Humanitas explains to us – can also be particularly dangerous and disabling.


What is peripheral obstructive arterial disease?

Peripheral obstructive arterial disease is a disorder resulting from the deposition of atherosclerotic plaques in the arteries, which cause difficulties in the passage of blood through the vessels or can even cause an occlusion.

When a tissue or organ is no longer receiving enough oxygen, an ischemia situation occurs, which causes necrosis of the tissue if left untreated.

Chronic peripheral obstructive arterial disease (CPOAD) affects the leg arteries.

When the blood passage is hindered, the muscles do not receive enough oxygen to function properly, causing the appearance of cramps that occur during walking. When the situation worsens, foot pain can also appear at night, and finally, in more serious cases, even ulcers and gangrene.


How is it diagnosed?

“The first step is to listen carefully to the symptoms reported by the patient,” explains Dr. Casabianca. “These are in fact extremely characteristic and associated with a vascular surgical examination in which the specialist can manually feel the pulsation of the arteries in the legs, thus allowing a first important clinical observation.

The second fundamental step is the EcoColor Doppler exam. This technique associates the ultrasound visualization of arterial vessels with the study of how blood flows inside them, using the Doppler method. It gives a clear idea of where any obstructions are located and how far they are extending.


How is it treated?

It is important to stress that a correct lifestyle is necessary, thus counteracting risk factors, which are mainly smoking and high cholesterol. When the control of risk factors is no longer sufficient, it is essential to ensure that blood flows back into the tissues.

You can act by trying to reopen the diseased arteries through minimally invasive interventions, such as balloon angioplasty possibly associated with stent placement.

In other cases, it is necessary to surgically intervene or manually clean the artery from plaque or by redirecting the blood from the occlusion zone through a new bypass to the tissues in the periphery.