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endarteritis obliterans[¦end‚ärt·ə′rīd·əs ō′blit·ə‚ränz]
a chronic disease of the peripheral blood vessels, mostly the arteries of the feet and legs. The lumens become smaller, and blood supply to the tissues is disturbed. The causes of the disease are obscure. There are several theories on the origin of the disease and more than 20 classifications of obliterative lesions of peripheral arteries. The disease mostly occurs in men under 50 years of age.
Factors that undoubtedly promote the development of endarteritis obliterans include smoking, frostbite and repeated prolonged chilling of the limbs (inducing protracted spasm of peripheral blood vessels), injury to the legs, neuritis, certain infectious diseases, and extreme mental stress. Impairment of tissue blood supply (caused by vascular spasm), abnormal growth of the intimal layer of the arterial wall, and thrombosis are manifested by coldness of the affected limb, pallor and increased moistness of the skin, sensitivity to cold, pain (including intermittent claudication, that is, pain in one or both legs when walking), weak pulsation of the corresponding blood vessels, trophic disorders, and other symptoms. The most severe manifestation of the disease is gangrene of the toes.
Modern instrumental methods of examination are useful in determining the degree of obstruction of a major artery and the development of collateral circulation. Among these methods are plethysmography, rheography, sphygmography, capillaroscopy, and angiography. Therapy is based on the stage of the disease. Initial stages may require clinical observation, drugs, physical therapy, or barotherapy. Acute cases and the late stages of chronic cases require hospitalization and, sometimes, surgery.
REFERENCESVishnevskii, A. A., N. I. Krakovskii, and V. Ia. Zolotarevskii. Obliteriruiushchie zabolevaniia arterii konechnostei. Moscow, 1972.
Zakharova, G. N. Obliteriruiushchii endarteriit konechnostei. [Saratov] 1972.
Akulova, R. F. Khronicheskaia arlerial’naia i venoznaia nedostatochnost’ konechnostei. Moscow, 1975.
Ecoiffier, J. La Pratique de l’angiographie. Paris, 1966.
V. R. ANAKHASIAN